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1968 Dr. Kirchner This 1968 image depicted the face and upper torso of a young child after receiving a smallpox vaccination in the right shoulder region. Note the erythematous halo surrounding the vaccination site, which can also be seen in PHIL 13321 and 13323, as well as a morbilliform skin rash, i.e., resembling measles, consisting of numerous flattened erythematous, amorphous macules. This child was subsequently diagnosed with roseola vaccinia. A variety of erythematous and urticarial rashes occur approximately 10 days after primary vaccination. These rashes are referred to as erythema multiforme, roseola vaccinia, toxic erythema, and postvaccinial urticaria.They are flat, erythematous, macular, or urticarial lesions, usually with microscopic vasculitis. The pathophysiology of these rashes is not well understood. They don't usually become vesicular, and don't appear to involve viral multiplication or systemic dissemination. The rash resolves spontaneously within 2 to 4 days.Patients with erythematous urticarial rashes associated with vaccinia are generally not severely ill and are usually afebrile despite the sometimes extensive skin involvement. On rare occasions Stevens-Johnson syndrome, or bullous erythema multiforme, may develop.