Orf or echthyma contagiosa

Orf--also known as ecthyma contagiosa--is a viral infection of the skin usually acquired from a goat or sheep. It is usually an occupational hazard seen in farmers, shepherds, veterinarians and abattoir workers. The orf virus belongs to the parapox subgroup of the pox viruses.


Initially, the patient develops an erythematous, inflammatory macule that develops into a red or blue-gray nodule. The hands or face are most commonly affected. Secondary bacterial infection may occur. Lymphadenopathy may be present. A bullous eruption [JAAD 2008:58;49-55] often identified as erythema multiforme may follow [Clin Infect Dis. 2013 Jun;56(11):1613, 1675-6].


No specific treatment is needed as the condition will spontaneously resolve in 6-8 weeks. One should watch for secondary bacterial infection. If needed, cryosurgery [Dermatology 1999;198;162] may be done. Multiple case reports have shown benefit with the use of topical imiquimod and this should be considered, especially in immunocompromised hosts. The wearing of gloves and proper hygiene when working with animals should be recommended. Rarely, surgical excision is performed.


Dermatologica Sinica 33 (2015) 191--195



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