In general,
the presence of a vaccination and the appearance of
the rash suffice to make a clinical diagnosis and no
further studies are required.
The vesicular and papular eruptions may be diagnostically
problematic, depending on the extent and evolution of
the individual lesions, as they may be mistaken for
generalized vaccinia or accidental autoinoculation.
The lesions of generalized vaccinia and accidental implantation
tend to occur later and to be devoid of massive erythematous
reactions and each evolves in a manner similar to primary
vaccinations.
Occasionally, virologic studies may be required to rule
out viral infection.
Appropriate allergic and immunologic studies may help
to gain a better understanding of their pathogenesis.
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