Disseminated Orf: An uncommon presentation

Maleeha Jawaid, Muhammad Irfan Anwar, Arfan Ul Bari


Orf or Ecthyma contagiosum is a viral dermatosis found mainly in animals, and in humans via zoonotic transmission from an infected animal. We herein, describe a case of Orf in an immunocompetent lady with a positive history of direct contact with a diseased animal in her neighbourhood. The patient presented to us in the out-patient department with multiple, large, ulcerated violaceous nodules on both her upper and lower limbs. The diagnosis was made on clinical grounds. It was later confirmed via histopathology. Where we might regard orf as a solitary appearing nodule, its unusual clinical patterns must not be missed in order to avoid unnecessary investigations and interventions.



Orf, Poxvirus, Ecthyma contagiosum

Full Text:



Groves RW, Wilson-Jones E, MacDonald DM. Human orf and milkers' nodule: A clinicopathologic study. J Am Acad Dermatol. 1991;25(4):706-11.

Bergqvist C, Kurban M, Abbas O. Orf virus infection. Rev Med Virol. 2017;27(4):e1932.

Spyrou V, Valiakos G. Orf virus infection in sheep or goats. Vet Microbiol. 2015; 181(1):178-82.

Espósito ACC, Jorge MFS, Marques MEA, Abbade LPF. Milker's nodules: classic histological findings. Anais brasileiros de dermatologia.2017;92(6):838-40.

Biazar T, Shokri M, Hosseinnia H, Bayani M. Erythema Multiforme as a Result of Orf Disease; a Case Report. Emergency (Tehran, Iran). 2016;4(3):163-5.

Zhao K, He W, Gao W, Lu H, Han T, Li J, et al. Orf virus DNA vaccines expressing ORFV 011 and ORFV 059 chimeric protein enhances immunogenicity. Virol J. 2011; 8:562.

Higgins E, Bennett M, Murphy A, Markham T. Disseminated parapox (orf) in a 13-year-old boy with atopic dermatitis following acupuncture. Clin Exp Dermatol. 2011; 36(7):809-11.

Sasmaz S, Uzel M, Sener S, Ucmak H. Rare presentation of human orf as multiple lesions. J Dermatol. 2011;38(8):825-6.

Hsu CH, Rokni GR, Aghazadeh N, Brinster N, Li Y, Muehlenbachs A, et al. Unique Presentation of Orf Virus Infection in a Thermal-Burn Patient After Receiving an Autologous Skin Graft. J Infec Dis. 2016;214(8):1171-4.

Afia Z, Robert S, Roger H, Mazhar N, Altaf A, Akhtar H, et al. Nosocomial Buffalopoxvirus Infection, Karachi, Pakistan. Emerg Infecti Dis. 2007;13(6):902.


  • There are currently no refbacks.

ISSN: 1560-9014