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Eczema vaccinatumImage:Eczema vaccinatum.jpeg Eczema vaccinatum was and might become again a rare severe adverse reactionto smallpoxvaccination. It is characterized by serious local or disseminated, umbilicated, vesicular, crusting skin rashesin the face, neck, chest, abdomen, upper limbs and hands, caused by widespread infectionof the skinin people with previous diagnosed skin conditions such as eczemaor atopic dermatitis, even if the conditions are not active at the time. Other signs and symptomsinclude feverand facial and supraglottic edema. The condition may be fatal if severe and not treated. Survivors are likly to have some scarring(pockmarks). Smallpox vaccine should not be given to patients with a history of eczema. Neither because of the danger of transmission of vaccinia, should people to whom it has been given closely contact anyone who has active eczema and has not been vaccinated. People with other skin diseases such as atopic dermatitis, burns, impetigo, or herpes zoster) also have an increased risk of contracting eczema vaccinatum and should not be vaccinated against smallpox. Differential diagnosis: A culture of vesicular fluid will grow vacciniavirus. Skin biopsyshows necroticepidermalcells with intranuclear inclusions. Eczema vaccinatum is a serious medical condition which requires immediate and intensivemedical care. Therapyhas been supportive, such as antibiotics, fluid replacement, antipyreticsand analgesics, skin healing, etc.; Vaccinia Immune Globulin(VIG) could be very useful but supplies may be defficient in 2006. Antiviral drugs have been examined for activity in pox viruses and Cidofovir is believed to be active CDC guidanceWHO.
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Categories: Vaccination| Dermatology
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