Orf disease: a report of a case

A 19 year-old Caucasian male shepherd, with no relevant medical history, presented to the Emergency Department of our hospital complaining about a necrotic lesion at the dorsal surface of his left hand (Fig. 1A). He mentioned that he had noticed similar lesions located at the lips and the breasts of his sheep (Fig. 1B). The diagnosis of Orf disease was clinically established, based on the typical presentation and the positive history of exposure. No special treatment was given to the patient, apart from local antiseptics, resulting in complete regression of the lesions within a month period. He was strongly advised to wear gloves when handling his animals and practice proper hand hygiene. Orf (or Contagious Ecthyma) is a zoonotic disease, caused by a parapoxvirus and mainly affects sheep and goats,¹ but it can be transmitted to humans through direct contact with infected animals.² It is generally considered as a self-limited clinical entity. However, successful treatment of complicated cases with topical use of imiquimod³ or cidofovir cream⁴ has been described in the literature.

Fig. 1
(A) Orf lesions located at the patient's hand and (B) at the breasts of his sheep.

REFERENCES

• ¹
  Paiba GA, Thomas DR, Morgan KL, et al. Orf (contagious pustular dermatitis) in farmworkers: prevalence and risk factors in three areas of England. Vet Rec. 1999;145:7–11.
• ²
  Groves RW, Wilson-Jones E, MacDonald DM. Human orf and milkers' nodule: a clinicopathologic study. J Am Acad Dermatol. 1991;25:706–11.
• ³
  Erbagci Z, Erbagci I, Almila Tuncel A. Rapid improvement of human orf (ecthyma contagiosum) with topical imiquimod cream: report of four complicated cases. J Dermatolog Treat. 2005;16:353–6.
• ⁴
  Geerinck K, Lukito G, Snoeck R, et al. A case of human orf in an immunocompromised patient treated successfully with cidofovir cream. J Med Virol. 2001;64:543–9.

Publication Dates

• Publication in this collection
  Sept-Oct 2014

History

• Received
  27 Mar 2014
• Accepted
  01 Apr 2014