Smallpox: What the Dermatologist Should Know

Phyllis I. Spuls, MD; Jan D. Bos, MD, PhD; Donald Rudikoff, MD


Skinmed. 2004;3(4) 

In This Article


The most important strategy for dealing with smallpox is prevention. Early diagnosis and vaccination within 4 days of exposure is the most important management strategy because it will prevent or ameliorate subsequent illness. Should treatment of smallpox be necessary, supportive therapy in a critical care unit (under strict isolation) would be imperative. Fluid management and antipyretics, topical therapy of mucosal and ocular lesions, and the treatment of bacterial infections would be important.

No antiviral agent has demonstrated reliable efficacy in clinical smallpox. Cidofovir, a nucleoside analog of deoxycytidine, shows in vitro activity against a broad spectrum of DNA viruses including variola, vaccinia, monkeypox, and molluscum contagiosum and might play a potential role should there be a future outbreak.[57,58,59]


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