An orf‐ful site
Authors: Joshua Farrell and Thomas J Stewart
Published online: 18 July 2022
An otherwise well 45-year-old sheep farmer presented to her general practitioner following a one-week history of tender reddish-blue nodules on the dorsal surface of her left hand

An otherwise well 45‐year‐old sheep farmer presented to her general practitioner following a one‐week history of tender reddish‐blue nodules on the dorsal surface of her left hand (Figure, A and B). She reported accompanying mild fevers and features consistent with regional lymphangitis. She wore fabric gloves for animal handling and could not recall recent contact with any sick animals. Polymerase chain reaction (PCR) testing of lesional fluid confirmed parapox virus and orf infection was diagnosed. Orf is a viral zoonotic cutaneous infection that is contracted via sheep and goats. It is highly contagious and transmission to humans occurs through direct contact with an infected lesion on an animal or contaminated equipment.1,2 The lesions typically resolve spontaneously without sequelae with standard wound care over several weeks. Referral for occupational health and safety advice may be considered.1,2
Competing interests
No relevant disclosures.
References
- Bergqvist C, Kurban M, Abbas O. Orf virus infection. Rev Med Virol 2017; 27; doi: https://doi.org/10.1002/rmv.1932.
- Bala JA, Balakrishnan KN, Abdullah AA, et al. The re‐emerging of orf virus infection: a call for surveillance, vaccination and effective control measures. Microb Pathog 2018; 120: 55‐63.