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Vaccinia—Progressive (Deep Tissue Involvement)

Progressive vaccinia is a nonhealing vesicular lesion that develops after smallpox vaccination and spreads broadly to involve skin other than the immunization site and deeply to involve bones and viscera. It occurs almost exclusively in vaccine recipients with an underlying defect in cell-mediated immunity.

Image courtesy of Dr. Allen W. Mathies of the Immunization Branch of the California Emergency Preparedness Office (Calif/EPO) via the Public Health Image Library of the Centers for Disease Control and Prevention.