“…Generalized vaccinia occurs once in 20,000 to 40,000 vaccinations,1 and in about two-thirds of such cases the condition develops in persons with diseases of the skin.2 During the 1947 mass vaccination campaign in New York City, the incidence of eczema vaccinatum was approximately one per 150,000 vaccinations. 3 Patients with atopic dermatitis seem to have a predilection for generalized infections with the viruses of vaccinia and herpes simplex. In 1887 Kaposi described an acute vesiculopustular febrile infection occurring in eczematous patients.…”