Serological diagnosis of chronic skin granulomas caused by wild-type or vaccine-derived rubella virus in patients with inherited HLA class I deficiency

Patients with TAP1/TAP2 deficiency develop rubella-associated skin granulomas due to impaired HLA-I antigen presentation. Markedly elevated rubella IgG levels may support diagnosis when PCR is unavailable. These findings also underscore the specific vulnerability of such patients to live-attenuated rubella vaccination.