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Published on: August 11, 2018
Clinical progression of a smallpox postvaccination response
Maggie H Zhou1, Shari R Lipner2, Stephen K Tyring3
1Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Proceedings (Baylor University. Medical Center)
|July 21, 2026
Summary
A smallpox vaccine can cause a self-limiting skin ulcer. Dermatologists should recognize this post-vaccination response to avoid misdiagnosis in military recruits and healthcare workers.
Area of Science:
- Dermatology
- Vaccinology
Background:
- The smallpox vaccine is administered to military recruits and healthcare workers.
- Cutaneous reactions can occur post-vaccination.
Purpose of the Study:
- To describe a case of a skin ulcer following smallpox vaccination.
- To raise awareness among dermatologists regarding this post-vaccination response.
Main Methods:
- Case report of a 20-year-old male military recruit.
- Clinical presentation of a non-necrotic, shallow, well-circumscribed shoulder ulcer.
Main Results:
- The patient developed a shoulder ulcer weeks after receiving the smallpox vaccine.
- The ulcer was consistent with a typical post-vaccination progression and was self-limited.
- Differential diagnoses considered included pyoderma gangrenosum, brown recluse bite, and Buruli ulcer.
Conclusions:
- The described skin ulcer is a characteristic, self-limited post-vaccination response to the smallpox vaccine.
- Awareness of this reaction is crucial for dermatologists to prevent misdiagnosis and unnecessary investigations.
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