Eczema Vaccinatum
Open Access
- 30 January 2012
- journal article
- review article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 54 (6) , 832-840
Abstract
Eczema vaccinatum (EV) is a complication of smallpox vaccination that can occur in persons with eczema/atopic dermatitis (AD), in which vaccinia virus disseminates to cause an extensive rash and systemic illness. Because persons with eczema are deferred from vaccination, only a single, accidentally transmitted case of EV has been described in the medical literature since military vaccination was resumed in the United States in 2002. To enhance understanding of EV, we review its history during the era of universal vaccination and discuss its relationship to complications in persons with other diseases or injuries of the skin. We then discuss current concepts of the pathophysiology of AD, noting how defective skin barrier function, epidermal hyperplasia, and abnormal immune responses favor the spread of poxviral infection, and identify a number of unanswered questions about EV. We conclude by considering how its occurrence might be minimized in the event of a return to universal vaccination.Keywords
This publication has 50 references indexed in Scilit:
- Atopic dermatitis: a disease of altered skin barrier and immune dysregulationImmunological Reviews, 2011
- Nonlesional atopic dermatitis skin is characterized by broad terminal differentiation defects and variable immune abnormalitiesJournal of Allergy and Clinical Immunology, 2011
- EGFR and IL-1 Signaling Synergistically Promote Keratinocyte Antimicrobial Defenses in a Differentiation-Dependent MannerJournal of Investigative Dermatology, 2011
- Postexposure Prevention of Progressive Vaccinia in SCID Mice Treated with Vaccinia Immune GlobulinClinical and Vaccine Immunology, 2011
- Development of atopic dermatitis-like skin disease from the chronic loss of epidermal caspase-8Proceedings of the National Academy of Sciences, 2010
- A randomized, double-blind, dose-finding Phase II study to evaluate immunogenicity and safety of the third generation smallpox vaccine candidate IMVAMUNE®Vaccine, 2010
- Vaccinia virus inoculation in sites of allergic skin inflammation elicits a vigorous cutaneous IL-17 responseProceedings of the National Academy of Sciences, 2009
- Phenotype of atopic dermatitis subjects with a history of eczema herpeticumJournal of Allergy and Clinical Immunology, 2009
- IL-22–producing “T22” T cells account for upregulated IL-22 in atopic dermatitis despite reduced IL-17–producing TH17 T cellsJournal of Allergy and Clinical Immunology, 2009
- Inhibition of NK cell activity by IL-17 allows vaccinia virus to induce severe skin lesions in a mouse model of eczema vaccinatumJournal of Experimental Medicine, 2009