Progress
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Cardiovascular
Orf (from Sheep & Goats)
Aetiology
Parapox virus infection, acquired from sheep & goats
Similar to Milker’s nodule
Clinical Features
Small, firm, red/reddish-blue lumps
Progresses to flat-topped pustules/blisters (2–3 cm, sometimes 5 cm)
Common sites: Hands, fingers, face
Lymphadenopathy, lymphangitis (red streaks) may occur
Management
Self-limiting (resolves in ~6 weeks)
Cover lesions to prevent secondary infection
Antibiotics if bacterial infection develops
Imiquimod cream may be effective in some cases
Orf (From Sheep & Goats)
Aetiology
Parapoxvirus infection acquired via direct contact with infected sheep or goats.
Similar clinical presentation to Milker’s Nodule (cattle-related parapox virus).
Typically no human-to-human transmission.
Clinical Features
Initial Lesions: Small, firm papules that are red to reddish-blue in colour.
Progression: Can evolve into flat-topped pustules or blister-like lesions (2–3 cm in diameter, sometimes up to 5 cm).
Common Sites: Hands, fingers, occasionally the face (especially in people handling the animals).
Lymphadenopathy or lymphangitis (red streaking) can occur due to local immune response.
Management
Self-Limiting: Typically resolves spontaneously in about 6 weeks.
Cover Lesions: Reduce the risk of secondary bacterial infection.
Antibiotics: Only if clear signs of secondary infection develop (e.g. local cellulitis, pus).
Imiquimod Cream: Has shown some benefit in recalcitrant lesions, though not always necessary.
Notes
Educate patients to use protective gloves and maintain good hand hygiene when dealing with infected sheep or goats to prevent further spread or re-infection.
Differential diagnoses include Milker’s Nodule, orf is sometimes also called “scabby mouth” in sheep/goats.
Typically no serious complications unless immunosuppressed or secondary infection arises.
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