A study to identify the differences in the transcriptional response to vaccinia virus (VV) in patients with atopic dermatitis (AD; n = 12) pr psoriasis (n = 12) versus healthy controls (n = 13) was conducted. The aim was to identify a defective pathway or pathways that may be involved in eczema vaccinatum (EV). Sixty-seven genes were significantly affected by VV in AD but not psoriatic or healthy skin. Genes associated with defense, response to wounding and immunity were predominantly affected. Skin gene expression was highly correlated with the Eczema Area and Severity Index (EASI) for certain genes such as Toll-like receptor 4 (r = -0.742; P = 0.0138); orosomucoid ...