This mutt-S/MIME howto is very helpful, but it doesn't explain how to add a correspondent's key to your database. Some notes for the future:
1. Once a correspondent sends you a signed message, you can extract their certificate from the signature. Save the "smime.p7s" attachment, and then run:
openssl pkcs7 -print_certs
-inform DER -in /tmp/smime.p7s
>/tmp/new-cert
2. To add this certificate to the certificate database, run:
smime_keys add_cert /tmp/new-cert
The smime_keys program is part of mutt, not the OpenSSL toolkit.
I used the correspondent's e-mail address as the label for the certificate, and mutt seems to pick up the recipient's certificate automatically, based on the e-mail address you're sending to.