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


Jennifer M. McNiff, MD,

Department of Pathology, Yale University, New Haven, CT, USA

Tel: 1 203 785 4094

Fax: 1 203 785 6869

e-mail: Jennifer.mcniff@yale.edu


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.