Eczema vaccinatum: Difference between revisions
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{{Short description|Adverse reaction to smallpox vaccine}} |
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| name = Eczema vaccinatum |
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'''Eczema vaccinatum''' is a rare severe [[adverse effect (medicine)|adverse reaction]] to [[smallpox vaccination]]. |
'''Eczema vaccinatum''' is a rare severe [[adverse effect (medicine)|adverse reaction]] to [[smallpox vaccination]]. |
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It is characterized by serious local or disseminated, umbilicated, vesicular, crusting [[skin rash]]es in the face, neck, chest, abdomen, upper limbs and hands, caused by widespread [[infection]] of the [[skin]] in people with previous diagnosed skin conditions such as [[eczema]] or atopic [[dermatitis]], even if the conditions are not active at the time. Other signs and [[symptoms]] include [[fever]] and facial and supraglottic [[edema]]. The condition may be fatal if severe and left untreated. Survivors are likely to have some [[scarring]] (pockmarks). |
It is characterized by serious local or disseminated, [[Umbilicated lesion|umbilicated]], vesicular, crusting [[skin rash]]es in the face, neck, chest, abdomen, upper limbs and hands, caused by widespread [[infection]] of the [[skin]] in people with previous diagnosed skin conditions such as [[eczema]] or atopic [[dermatitis]], even if the conditions are not active at the time. Other signs and [[symptoms]] include [[fever]] and facial and supraglottic [[edema]]. The condition may be fatal if severe and left untreated. Survivors are likely to have some [[scarring]] (pockmarks). |
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Smallpox vaccine should not be given to patients with a history of eczema. Because of the danger of transmission of [[vaccinia]], it also should not be given to people in close contact with anyone who has active eczema and who has not been vaccinated. People with other skin diseases such as atopic dermatitis, [[burn (injury)|burns]], [[impetigo]], or [[herpes zoster]]) also have an increased risk of contracting eczema vaccinatum and should not be vaccinated against smallpox. |
Smallpox vaccine should not be given to patients with a history of eczema. Because of the danger of transmission of [[vaccinia]], it also should not be given to people in close contact with anyone who has active eczema and who has not been vaccinated. People with other skin diseases (such as atopic dermatitis, [[burn (injury)|burns]], [[impetigo]], or [[herpes zoster]]) also have an increased risk of contracting eczema vaccinatum and should not be vaccinated against smallpox. |
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==Presentation== |
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===Associations=== |
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==Diagnosis== |
==Diagnosis== |
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A culture of vesicular fluid will grow [[vaccinia]] [[virus]]. Skin [[biopsy]] shows [[necrosis|necrotic]] [[Epidermis (skin)|epidermal]] cells with intranuclear inclusions. |
A culture of vesicular fluid will grow [[vaccinia]] [[virus]]. Skin [[biopsy]] shows [[necrosis|necrotic]] [[Epidermis (skin)|epidermal]] cells with intranuclear inclusions.{{cn|date=May 2021}} |
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==Treatment== |
==Treatment== |
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Eczema vaccinatum is a serious medical condition that requires immediate and [[intensive care|intensive]] medical care. Therapy has been |
Eczema vaccinatum is a serious medical condition that requires immediate and [[intensive care|intensive]] medical care. Therapy has been [[supportive care|supportive]], such as [[antibiotic]]s, [[fluid replacement]], [[antipyretics]] and [[analgesics]], skin healing, etc.; [[vaccinia immune globulin]] (VIG) could be very useful but supplies may be deficient as of 2006. Antiviral drugs have been examined for activity in pox viruses and [[cidofovir]] is believed to display potential in this area.<ref>[https://www.cdc.gov/ncidod/monkeypox/treatmentguidelines.htm CDC guidance]{{Dead link|date=July 2024}}</ref><ref>{{Cite web |date=2004-07-04 |title=WHO: Cidofovir Treatment of Variola (Smallpox) in the Hemorrhagic Smallpox Primate Model and the IV Monkeypox Primate Model |url=http://www.who.int/csr/disease/smallpox/cidofovirtreatment/en/ |access-date=2024-07-06 |archive-url=https://web.archive.org/web/20040704124330/http://www.who.int/csr/disease/smallpox/cidofovirtreatment/en/ |archive-date=2004-07-04 }}</ref> |
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==21st-century cases== |
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In March 2007, a two-year-old |
In March 2007, a two-year-old boy and his mother in Indiana contracted the life-threatening [[vaccinia]] infection from his father who was vaccinated against smallpox as part of the standard vaccination protocol for individuals serving in the [[United States Armed Forces|US Armed Forces]] beginning in 2002. The child developed the [[pathognomonic]] rash which typifies eczema vaccinatum over 80 percent of his body surface area. The boy has a history of eczema, which is a known risk factor for vaccinia infection.<ref>{{cite news |url=https://www.nytimes.com/2007/05/18/health/18smallpox.html?_r=1&ref=health&oref=slogin |title=Soldier's Smallpox Inoculation Sickens Son|last=Schwartz|first=John |work=New York Times |date=2007-05-18 |access-date=2007-05-18}}</ref> |
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== See also == |
== See also == |
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* [[List of cutaneous conditions]] |
* [[List of cutaneous conditions]] |
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* [http://dermatology.about.com/library/bldefeczvacc.htm Eczema vaccinatum]. About. |
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==References== |
==References== |
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{{Viral cutaneous conditions}} |
{{Viral cutaneous conditions}} |
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{{External causes of morbidity and mortality}} |
{{External causes of morbidity and mortality}} |
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[[Category:Virus-related cutaneous conditions]] |
[[Category:Virus-related cutaneous conditions]] |
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[[Category:Complications of surgical and medical care]] |
[[Category:Complications of surgical and medical care]] |
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[[Category:Eczema]] |
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Latest revision as of 18:50, 2 August 2024
 | This article needs to be updated. (July 2024) |
| Eczema vaccinatum | |
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| 8 month old boy developed eczema vaccinatum after acquiring vaccinia from a sibling recently vaccinated for smallpox. | |
| Specialty | Infectious disease |
Eczema vaccinatum is a rare severe adverse reaction to smallpox vaccination.
It is characterized by serious local or disseminated, umbilicated, vesicular, crusting skin rashes in the face, neck, chest, abdomen, upper limbs and hands, caused by widespread infection of the skin in people with previous diagnosed skin conditions such as eczema or atopic dermatitis, even if the conditions are not active at the time. Other signs and symptoms include fever and facial and supraglottic edema. The condition may be fatal if severe and left untreated. Survivors are likely to have some scarring (pockmarks).
Smallpox vaccine should not be given to patients with a history of eczema. Because of the danger of transmission of vaccinia, it also should not be given to people in close contact with anyone who has active eczema and who 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.
Presentation
[edit]Associations
[edit]Eczema is also associated with increased complications related to other vesiculating viruses such as chickenpox; this is called eczema herpeticum.[citation needed]
Diagnosis
[edit]A culture of vesicular fluid will grow vaccinia virus. Skin biopsy shows necrotic epidermal cells with intranuclear inclusions.[citation needed]
Treatment
[edit]Eczema vaccinatum is a serious medical condition that requires immediate and intensive medical care. Therapy has been supportive, such as antibiotics, fluid replacement, antipyretics and analgesics, skin healing, etc.; vaccinia immune globulin (VIG) could be very useful but supplies may be deficient as of 2006. Antiviral drugs have been examined for activity in pox viruses and cidofovir is believed to display potential in this area.[1][2]
21st-century cases
[edit]In March 2007, a two-year-old boy and his mother in Indiana contracted the life-threatening vaccinia infection from his father who was vaccinated against smallpox as part of the standard vaccination protocol for individuals serving in the US Armed Forces beginning in 2002. The child developed the pathognomonic rash which typifies eczema vaccinatum over 80 percent of his body surface area. The boy has a history of eczema, which is a known risk factor for vaccinia infection.[3]
See also
[edit]References
[edit]- ^ CDC guidance[dead link]
- ^ "WHO: Cidofovir Treatment of Variola (Smallpox) in the Hemorrhagic Smallpox Primate Model and the IV Monkeypox Primate Model". 2004-07-04. Archived from the original on 2004-07-04. Retrieved 2024-07-06.
- ^ Schwartz, John (2007-05-18). "Soldier's Smallpox Inoculation Sickens Son". New York Times. Retrieved 2007-05-18.
External links
[edit]- Side Effects of Smallpox Vaccination. Centers for Disease Control and Prevention Fact Sheet.
- Vaccine Reaction Images. CDC.