Eczema vaccinatum

Eczema Vaccinatum

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Eczema vaccinatum

Eczema vaccinatum is a rare severe adverse reaction

Adverse effect (medicine)

In medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as chemotherapy or surgery....
to smallpox

Smallpox

Smallpox is an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning spotted, or varus, meaning "pimple"....
vaccination

Vaccination

Vaccination is the administration of antigenic material to produce immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by a pathogen....
.

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

Infection

An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host resources to multiply ....
of the skin

Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
in people with previous diagnosed skin conditions such as eczema

Eczema

Eczema is a form of dermatitis, or inflammation of the epidermis. The term eczema is broadly applied to a range of persistent skin conditions....
or atopic dermatitis

Dermatitis

Dermatitis is a blanket term meaning any "inflammation of the skin" . There are several different types of dermatitis. The different kinds usually have in common an allergic reaction to specific allergens....
, even if the conditions are not active at the time. Other signs and symptoms include fever

Fever

Fever is a frequent medical sign that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1?2 ?C ....
and facial and supraglottic edema

Edema

File:Oedema.jpgEdema or Oedema , formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body....
.

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Encyclopedia

Eczema vaccinatum is a rare severe adverse reaction

Adverse effect (medicine)

In medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as chemotherapy or surgery....
to smallpox

Smallpox

Vaccination

Infection

An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host resources to multiply ....
of the skin

Skin

Eczema

Eczema is a form of dermatitis, or inflammation of the epidermis. The term eczema is broadly applied to a range of persistent skin conditions....
or atopic dermatitis

Dermatitis

Fever

Edema

File:Oedema.jpgEdema or Oedema , formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body....
. The condition may be fatal if severe and not treated. 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

Burn (injury)

A burn is a type of injury that may be caused by heat, Temperature, electricity, chemicals, light, radiation, or friction. Burns can be highly variable in terms of the tissue affected, the severity, and resultant complications....
, impetigo

Impetigo

Impetigo is a superficial bacterial skin infection most common among children 2 to 6 years old. People who play close contact sports such as rugby football, American football and wrestling are also susceptible, regardless of age....
, or herpes zoster

Herpes zoster

Herpes zoster , commonly known as shingles, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe....
) also have an increased risk of contracting eczema vaccinatum and should not be vaccinated against smallpox.

Differential diagnosis
Differential diagnosis

A differential diagnosis is a systematic method used to identify unknowns. This method, essentially a process of elimination, is used by taxonomy to identify living organisms, and by physicians and other qualified healthcare professionals to diagnosis the specific disease in a patient....
: A culture of vesicular fluid will grow vaccinia

Vaccinia

Virus

A virus is a Optical microscope#Limitations of light microscopes infectious agent that is unable to grow or reproduce outside a host cell . Viruses infect all cellular life....
. Skin biopsy

Biopsy

A biopsy is a medical test involving the removal of Cell_s or Biological tissues for examination. It is the removal of tissue from a living subject to determine the presence or extent of a disease....
shows necrotic

Necrosis

Necrosis is the name given to premature death of cell s and living biological tissue. Necrosis is caused by external factors, such as infection, toxins, or trauma....
epidermal

Epidermis (skin)

The epidermis is the outermost layer of the skin, composed of terminally differentiated stratified squamous epithelium, acting as the body's major barrier against an inhospitable environment....
cells with intranuclear inclusions.

Eczema vaccinatum is a serious medical condition which requires immediate and intensive medical care. Therapy has been supportive, such as antibiotic

Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
s, fluid replacement

Fluid replacement

Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes....
, antipyretics and 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 .

Eczema also mixes poorly with other vesiculating viruses such as Chickenpox - see eczema herpeticum

Eczema herpeticum

Eczema herpeticum is a rare but severe Disseminated disease herpes infection that generally occurs at sites of skin damage produced by, for example, atopic dermatitis, burns, or eczema....
.

Recent Cases

In March 2007, a two-year-old Indiana boy and his mother contracted the life-threatening vaccinia

Vaccinia

Vaccinia virus is a large, complex, Viral envelope virus belonging to the poxvirus family. It has a linear, double-stranded DNA genome approximately 190 base pair in length, and which encodes for approximately 250 genes....
infection from his soldier father's smallpox vaccination. The boy developed the telltale rash over 80 percent of his body after coming into close contact with his father, who was vaccinated for smallpox before being deployed overseas by the Army (the military resumed smallpox vaccinations in 2002). The child acquired the infection due to eczema, which is a known risk factor for vaccinia infection. He continues to be in a critical condition, but is slowly improving.

External links

. Centers for Disease Control and Prevention Fact Sheet.
. CDC.
. About.