Regional Folliculitis After Smallpox Vaccination

For a week, a 36-year-old Marine had clusters of localized papular lesions on the right forearm; he had no systemic symptoms. The patient had been inoculated 20 days earlier in the United States with the vaccinia virus (smallpox vaccine) to the ipsilateral shoulder just before deployment. He had no history of eczema, psoriasis, or drug allergies.

Three patches of nonpustular folliculitis were observed on the patient’s right forearm (A). However, the inoculation site on the right shoulder was healing well (B). No treatment was required. The folliculitis healed without scarring 10 days later.

Regional folliculitis has been previously reported in adults who received the smallpox vaccine for the first time at rates as high as 7.4%.¹ This was the only identified case of regional folliculitis in a group of slightly more than 100 vaccinated persons.

References:

REFERENCE:

1

. Talbot TR, Brendenberg HK, Smith M, et al. Focal and generalized folliculitis following smallpox vaccination among vaccinia-naive recipients.

JAMA.

2003;289:3290-3294.