Orf – contagious viral skin disease
Orf is a viral skin disease caused by parapoxvirus. The virus spreads to humans with the handling of infected sheep and goats. It is also known as contagious ecthyma, contagious pustular dermatitis and scabby mouth. This article describes the case of orf in a 45-year-old male patient.
The patient presented to the emergency with a complaint of a 2-week history of an enlarging lesion on his left thumb. The lesion had first appeared as a targetoid and enlarged progressively. However, there were no signs of pain or sensory deficits. The patient’s history revealed that he had come in contact with sheep 3 weeks earlier. His duties included handling meat on a farm. Examination of the lesion showed an edematous and dusky nodule located on the dorsal surface of the left thumb. Further examination showed that the lesion was unroofed.
Doctors advised bacterial, mycobacterial, and fungal cultures of samples from the lesion, the results of which were negative. Since the patient’s history was significant of direct contact with sheep, doctors diagnosed him with orf.
The disease typically progresses from targetoid papule to a boggy nodule.
The disease progresses from a targetoid papule to a boggy nodule. Similarly, subsequently dries out and resolves without the need for treatment other than simple wound care. In this particular case the lesion dried over 3 weeks and became less oedematous. The lesions are generally firm, red or blue in colour, measuring 2 to 5 cm in diameter. Orf lesions are usually small, red, itchy and painful, moreover, usually appear after an incubation period of 3 to 5 days.
At the patient’s 6-month follow-up, the lesion had healed completely with just mild skin sensitivity.