1/34. Facial orf. Orf is an occupational dermatosis caused by a poxvirus that infects sheep or goats. Human transmission typically occurs in people in contact with the infected animals or by handling contaminated animal products such as wool or meat. The infection in humans is classically characterized by a solitary papule on the fingers or hands. Involvement of the face or head has rarely been reported. We report orf in a young woman with multiple nodules on the face. ( info) |
| A 48-year-old patient under immunosuppressive therapy for renal transplantation had contagious ecthyma which relapsed after excision. Stable healing was obtained by cryotherapy. ( info) |
3/34. A case of human orf in an immunocompromised patient treated successfully with cidofovir cream. Immunocompromised patients may have severe forms of infections. Since there is an increasing number of patients maintained under immunosuppressive therapy, we will be confronted with increasing frequency with these infectious problems. Effective treatments will be of great value. The case is described of a renal transplant with a giant orf lesion, which continued growing instead of regressing spontaneously as is observed usually. The treatment options in such patients are limited. It was decided to treat the patient with the antiviral drug cidofovir (HPMPC, Vistide. Topical cidofovir treatment resulted in complete regression of the lesion. This case is discussed in the context of the known literature on orf (ecthyma contagiosum). ( info) |
4/34. Giant orf on the nose. ecthyma contagiosum, or orf, is a viral zoonosis of sheep and goats that can be transmitted to humans. In humans, it generally manifests as a solitary skin lesion, although rarely it can have an unusual course or be accompanied by systemic symptoms or complications. We present a case of giant orf lesion on the nose of a 9-year-old. The lesion grew rapidly and measured 5 cm by 4 cm and was attached to the right ala nasi by a base 2 cm round in diameter. The diagnosis was suggested by clinical and histopathologic appearance and confirmed by electron microscopic visualization of the virus. The lesion resolved spontaneously with minimal scarring and the entire cycle lasted about 3 months. ( info) |
5/34. A case of human orf contracted from a deer. Orf, or contagious ecthyma, is a rare viral dermatosis caused by a member of the genus parapoxvirus. The typical lesion consists of solitary or multiple papules that progress through a series of stages, terminating in complete resolution. This zoonotic disease is most commonly transmitted to humans from infected sheep or goats. We report a case of human orf, likely contracted from exposure to deer carcasses. ( info) |
6/34. Human labial orf: a case report. A case of orf in a 59-year-old man with no direct contact with farm animals is reported. The patient presented with an ulcerating lesion on the upper lip and the diagnosis was confirmed by electron microscopy from a smear of the lesion. The unusual case history, differential diagnosis and method of diagnosis are discussed. ( info) |
7/34. Swan-neck deformity and paresthesia following giant orf. Orf is a zoonotic infection caused by a parapoxvirus that primarily infects sheep and goats. Human orf infection can take place when abraded skin comes into contact with infected animals. It occurs most commonly on the index finger. The characteristic lesion resembles a tumor and resolves spontaneously, usually without any complications. However, rare complications such as lymphangitis, adenitis, erythema multiforme, erysipelas, papulovesicular eruption, pseudomonas aeruginosa infection, and bullous pemphigoid have been reported. Herein, we report a case of giant orf causing swan-neck deformity and paresthesia. These complications have not been previously reported in the literature. ( info) |
| The orf virus is the causal agent of contagious ecthyma in goats and sheep. The infection can be transmitted to humans and represents a typical example of occupational zoonosis. In italy, the incidence of human infection remains uncertain because the disease is rarely reported or diagnosed. In this paper, we report a case of human orf virus infection and the laboratory methods of diagnosis. We demonstrated a genomic identity between the conserved and the variable regions of the genome of the viral strains isolated from the human patient and from the infected sheep confirming that there is no specific clone infecting humans rather than animals. ( info) |
9/34. Rapid improvement of human orf (ecthyma contagiosum) with topical imiquimod cream: report of four complicated cases. Orf is a zoonosis caused by an epitheliotropic dna parapox virus. Human orf is a generally benign, self-limiting condition that usually regresses in 6-8 weeks without specific treatment. However, it may be accompanied by local symptoms including pain, pruritus, lymphangitis and axillary adenitis, or less frequently by systemic symptoms such as fever or malaise. Furthermore, it may be complicated by erythema multiforme, stevens-johnson syndrome, erysipelas, generalized mucocutaneous eruption, toxic erythema, eyelid oedema and giant, persistent or recurrent lesions in immunocompromised patients. Imiquimod, a potent topical immune response modifier, enhances both the innate and acquired immunity by stimulation of immune system cells resulting in local antiviral, antitumour and immunoregulatory activity. We present, for the first time, four complicated cases of orf successfully treated by topical imiquimod resulting in rapid regression of both orf and associated lesions. Two of the cases were complicated with erythema multiforme, one with recurrent eyelid oedema, and another had giant orf associated with axillary lymphadenitis. We suggest that topical imiquimod may be an effective and safe therapy for complicated orf cases. ( info) |
| orf virus is a zoonotic parapoxvirus endemic to most countries in the world and is principally associated with small ruminants (e.g., sheep and goats). Human orf infections appear as ulcerative skin lesions after contact with an infected animal or contaminated fomite. This report summarizes the epidemiologic and laboratory investigations of four sporadic cases of human orf infection, emphasizing the temporal association between human lesions and skin trauma or recent flock vaccination with live orf vaccine. This zoonotic infection shares clinical manifestations and exposure risks with other, potentially life-threatening zoonoses (e.g., cutaneous anthrax) and is likely under-recognized because of a lack of clinical suspicion and widely available diagnostics. Barrier precautions and proper hand hygiene are recommended for the prevention of orf virus infection in humans. ( info) |