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The clinical appearance of lesions together with a primary vaccination site usually establishes the diagnosis.
Diagnosis may be more difficult in contact cases, because history of contact with a vaccinee may be unknown or
unappreciated as to risk.
Laboratory confirmation may be indicated in cases where distinction from herpes virus infection or other pox diseases
may be necessary. Immunologic studies, particularly of T-cell function and IgE levels, are recommended and should be
performed in consultation with either the CDC or an established immunologist familiar with atopic dermatitis. In this way,
the subtle immunologic differences that contribute to the occurrence and morbidity of this condition may be better understood.
Appropriate bacterial and/or fungal cultures of the skin or blood may be indicated if there is evidence of contamination or
symptoms suggesting bacteremia or septicemia. If abscesses occur, treat appropriately by incision and drainage.
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