Expanding the histologic findings in smallpox-related post-vaccinial non-viral folliculitis

J Cutan Pathol. 2013 Mar;40(3):305-9. doi: 10.1111/cup.12064. Epub 2012 Dec 20.

Abstract

Post-vaccinial non-viral folliculitis has been recognized in the past decade as a new adverse cutaneous reaction to smallpox vaccination. Contrary to more serious smallpox vaccine reactions, post-vaccinial non-viral folliculitis has a benign course and resolves spontaneously within approximately 7 days. We describe additional histopathologic findings associated with post-vaccinial non-viral folliculitis, which has only been described once previously. New findings include the presence of a neutrophilic or lymphohistiocytic infiltrate that is concentrated around the hair follicles. We compare our findings to the follicular nature of varicella and herpes zoster infections, generating the hypothesis of deposition of vaccinia protein within folliculosebaceous units as a potential pathophysiologic mechanism behind post-vaccinial non-viral folliculitis.

Keywords: bioterrorism; folliculitis; smallpox; vaccine; vaccinia.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Folliculitis* / etiology
  • Folliculitis* / metabolism
  • Folliculitis* / pathology
  • Hair Follicle / metabolism*
  • Hair Follicle / pathology*
  • Humans
  • Male
  • Smallpox Vaccine / administration & dosage
  • Smallpox Vaccine / adverse effects*

Substances

  • Smallpox Vaccine