This image depicts the dorsum of the right hand of a 71 year-old woman revealing a metastatic lesion of vaccinia necrosum, also known as progressive vaccinia. The margins of this lesion display the characteristic of typical confluent vaccinial growth. Despite intensive treatment, this patient died, and was found to have a deficiency in her cellular immunity mechanism.
Progressive vaccinia is one of the most severe complications of smallpox vaccination. It is almost always life threatening. Progressive vaccinia is the preferred designation for this complication although, in the past, it has sometimes been termed: - Vaccinia necrosum - Vaccinia gangrenosa - Disseminated vaccinia Rare in the past, it may be a greater threat today, given the larger proportion of susceptible persons in the population.
Dr. Clement R. Boughton of Sydney, Australia, furnished this published photograph.
Source: CDC/ Dr. Clement R. Boughton of Sydney, Australia