Flat and hemorrhagic types of smallpox are treated with the same therapies used to treat shock, such as fluid resuscitation. People with semi-confluent and confluent types of smallpox may have therapeutic issues similar to patients with extensive skin burns.In July 2018, the Food and Drug Administration approved tecovirimat, the first drug approved for treatment of smallpox. Antiviral treatments have improved since the last large smallpox epidemics, and studies suggest that the antiviral drug cidofovir might be useful as a therapeutic agent. The drug must be administered intravenously, and may cause serious kidney toxicity.ACAM2000 is a smallpox vaccine developed by Acambis. It was approved for use in the United States by the U.S. FDA on August 31, 2007. It contains live vaccinia virus, cloned from the same strain used in an earlier vaccine, Dryvax. While the Dryvax virus was cultured in the skin of calves and freeze-dried, ACAM2000s virus is cultured in kidney epithelial cells (Vero cells) from an African green monkey. Efficacy and adverse reaction incidence are similar to Dryvax. The vaccine is not routinely available to the US public; it is, however, used in the military and maintained in the Strategic National Stockpile.In June 2021, brincidofovir was approved for medical use in the United States for the treatment of human smallpox disease caused by variola virus.
A malignant chondroid syringoma (also known as a "malignant mixed tumour" or "MCS" ) is a very uncommon cutaneous (skin) condition characterised by an adnexal eccrine tumour. : 667 It is commonly reported to present on the trunk and extremities and behave in an aggressive manner. MCS is a cancerous subtype of its benign counterpart, chondroid syringoma, and is the least common variation that has an approximated prevalence of less that 0.005%. These tumours mainly arise "from sebaceous glands, sweat glands, and ectopic salivary glands" (Tural, Selçukbiricik, Günver, Karışmaz, and Serdengecti, 2013) and are rarely encountered in radiopathological and clinical practice. The tumours commonly appear with an asymptomatic "slow-growing, painless, solid subcutaneous or intradermal nodules with a normal margin" (Obaidat, Alsaad, and Ghazarian, 2007) and make up for less than one percent of all primary skin tumours. Commonly appearing in the limbs and body, these asymmetrical tumours range from two millimetres to more than three centimetres. MCS is one of the rarest subtypes of tumours and usually requires aggressive surgery to terminate. Despite accounting for only a small number of tumours recorded each year, malignant mixed tumours are easily confused with other skin conditions (such as epidermal cyst, pilar cyst, calcifying epithelioma, or a solitary trichoepithelioma (Tural, Selçukbiricik, Günver, Karışmaz, and Serdengecti, 2013)) and have high potential for recurrence after surgical excision. The aggressiveness of malignant chondroid syringoma varies, as 49% of cases have had local recurrence whereas some demonstrate regional lymph node or osseous metastasis.