Materiały źródłowe

• #1 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. […] A lesion appears 3 to 7 days after contact with an infected animal and evolves slowly over the course of 4 to 8 weeks. It starts as a firm red painful papule that expands into a broad, thickened 1- to 3-cm lesion. The centre of the lesion is red and is surrounded by a white, raised ring with erythematous periphery. The crusting occurs and resolves by 3 to 6 weeks with little to no scarring.

• #2 Orf | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/orf

  Orf is a viral skin disease that can be spread to humans by handling infected sheep and goats. […] In humans, the first sign of orf is a small, red, itchy or painful lump (lesion) that usually appears on the fingers, hands, forearms or face after an incubation period of 3 to 5 days. […] The lesion will usually be firm, red or blue in colour, and 2 to 5cm in diameter. […] As the condition progresses over a 3- to 6-week period, a pustule or blister that weeps fluid will develop on top and eventually crust over. […] Other possible symptoms include a high temperature, general tiredness (fatigue) and enlarged lymph glands.

• #3 Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-08998-7

  Orf virus (ORFV) is the pathogen responsible for Orf, a zoonotic viral infection that can be spread to humans from sheep and goats. […] A 51-year-old woman with no previous medical history presented with a one-week history of three asymptomatic swelling nodules with a grey necrotic center and red outer halo on her index finger. At physical examination there was also a pruritic papulovesicular eruption on her hands and feet. […] The lesions spontaneously resolved within the next 2 weeks. […] Human infection typically manifests as a single papule or nodule 3 to 7 days after inoculation. It progresses through 6 stages before spontaneous remission occurs 6 to 8 weeks later. […] Current studies suggest that ORFV can cause a variety of hypersensitivity reactions being erythema multiforme (EM) the most common immunological consequence recorded, which typically appears before the primary lesions have completely healed and generally 3 weeks following the onset of Orf.

• #4 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #5 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. […] A lesion appears 3 to 7 days after contact with an infected animal and evolves slowly over the course of 4 to 8 weeks. It starts as a firm red painful papule that expands into a broad, thickened 1- to 3-cm lesion. The centre of the lesion is red and is surrounded by a white, raised ring with erythematous periphery. The crusting occurs and resolves by 3 to 6 weeks with little to no scarring.

• #6 Orf | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/orf

  Orf is a viral skin disease that can be spread to humans by handling infected sheep and goats. […] In humans, the first sign of orf is a small, red, itchy or painful lump (lesion) that usually appears on the fingers, hands, forearms or face after an incubation period of 3 to 5 days. […] The lesion will usually be firm, red or blue in colour, and 2 to 5cm in diameter. […] As the condition progresses over a 3- to 6-week period, a pustule or blister that weeps fluid will develop on top and eventually crust over. […] Other possible symptoms include a high temperature, general tiredness (fatigue) and enlarged lymph glands.

• #7 Orf

  https://www.nhs.uk/conditions/orf/

  Orf is a skin infection you can get from infected sheep or goats. It most often affects the fingers, hands, forearms or face. It usually clears up without treatment in about 6 weeks. […] Orf usually affects the skin on your fingers, hands, forearms or face. A circular, purple mark on the middle finger of a person with white skin. The mark is slightly smaller than their fingernail. To start with, the affected area of skin is small and may look a reddish-blue colour. It may be itchy or tender. […] Over a few weeks, the affected area of skin gets bigger and turns into a blister. The blister is usually 2 to 3cm, but it can grow up to 5cm. It may leak fluid before crusting over. […] Other symptoms of orf include a high temperature, general tiredness (fatigue), swollen glands on the inside of your elbow or under your arm.

• #8

  https://dermnetnz.org/topics/orf

  Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. […] After an incubation period of 56 days, a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 23 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. […] Red streaks up the lymph channels (lymphangitis) with enlargement of the lymph glands on the inner side of the elbow and/or under the arm (lymphadenopathy) are not uncommon. There may be a mild fever. […] Patients who are immune deficient or immune suppressed may develop larger or unusual orf lesions. Rarely widespread small blisters may occur, suggesting blood stream spread of the orf virus, but resolve after a few weeks.

• #9

  https://dermnetnz.org/topics/orf

  Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. […] After an incubation period of 56 days, a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 23 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. […] Red streaks up the lymph channels (lymphangitis) with enlargement of the lymph glands on the inner side of the elbow and/or under the arm (lymphadenopathy) are not uncommon. There may be a mild fever. […] Patients who are immune deficient or immune suppressed may develop larger or unusual orf lesions. Rarely widespread small blisters may occur, suggesting blood stream spread of the orf virus, but resolve after a few weeks.

• #10 Unusual Presentation of Orf in an Otherwise Healthy Individual | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0399

  Orf is a common parapoxvirus infection of sheep and goats that can be transmitted to humans by direct inoculation of infected material. In humans, a solitary (or in some cases, a few) small, firm, red or reddish-blue papule enlarges to form a flat-topped haemorrhagic pustule or bulla, typically 13 cm in diameter, but sometimes as large as 5 cm in diameter. There may be mild fever, malaise and regional adenitis. Spontaneous recovery normally occurs in 36 weeks. […] Unusual presentations, such as giant orf, primarily in immunosuppressed individuals, or widespread, papulovesicular or bullous lesions have been reported. […] The clinical observations and medical history were compatible with the virus infection orf following contact with an infected sheep. […] The secondary infection was treated with dicloxacillin for 10 days, otherwise spontaneous recovery was awaited. Spontaneous regression was observed, and after 4 months the lesion has healed with only minor scarring.

• #11 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #12

  https://zana.com/a/orf-symptoms-orf.7069

  In humans, the first sign of orf is a small, red, itchy or painful lump (lesion) that usually appears on the fingers, hands, forearms or face after an incubation period of three to five days. In some cases there may be more than one lesion. […] The lesion will usually be firm, red or blue in colour and 2-5cm in diameter. […] As the condition progresses over a three- to six-week period, a pustule or blister that weeps fluid will develop on top and eventually crust over. […] Other possible symptoms include a mild fever (high temperature), general tiredness (fatigue) and enlarged lymph glands.

• #13 Orf Disease – DoveMed

  https://www.dovemed.com/diseases-conditions/orf-disease

  Orf Disease is an infection caused by the parapoxvirus, Orfviridae. It is a zoonotic disease – one that is transmitted from animals to humans. The virus is primarily found in animals, such as sheep and goats, but it may be transmitted to humans via close contact, usually through open wounds. […] The disease results in the formation of tender skin lesions, commonly on the fingers and hands. This may be rarely accompanied by low-grade fever and swollen lymph nodes. Orf Disease is generally not a severe illness and the affected individuals usually get better within about 6 weeks, with adequate treatment (such as topical applications). […] The signs and symptoms of Orf Disease may vary from one individual to another, and it may be mild or severe. These may include: Presence of well-defined and firm skin lesions that appear as red papules. The papules then form blisters with blood and pus. The blisters break and ooze pus to then form a firm crusted lesion. Following this, they heal with minimal to no scarring. The lesions are usually tender and sometimes painful, particularly in the initial stages. Many individuals present a solitary lesion, but multiple lesions are not uncommon. Any part of the body may present the lesion, although common sites are the fingers, hands, and arms. Sometimes, the face, eye, or even the penis may be affected. The size of most lesions are between 2 to 3 cm, but some may be as large as 5 cm. As the blister heals, it can temporarily leave a rough pebble-like appearance before transitioning to normal. At this stage, no treatment is generally needed. […] Sometimes, mild fever and enlarged lymph nodes (on the arms) may be noted. […] The prognosis of Orf Disease is usually good since it is a self-limiting infection that resolves spontaneously within about 6 weeks.

• #14 What Is Orf Virus?

  https://www.webmd.com/a-to-z-guides/what-is-orf-virus

  As it progresses, the lesion will dry out, and you’ll notice tiny black spots forming on the surface. Finally, the lesion becomes flat, and a dry crust forms around it. At this point, the healing process begins. […] Though they are rare, complications can occur. You’re at a greater risk of complications if you’re immunocompromised due to conditions like HIV or chemotherapy treatments. Complications may include bacterial infection, a rash that looks like a bulls-eye target, or a skin condition known as bullous pemphigoid, which forms large blisters. […] Additionally, humans may develop some immunity to the orf virus after their initial infection, though subsequent infections can still occur. However, any following orf infections may present less severe symptoms.

• #15 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #16 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  Orf viral infection, also known as ecthyma contagiosum or contagious pustular dermatitis, is an occupational disease primarily acquired from infected sheep and goats. […] Orf passes through 6 clinical stages and is usually diagnosed with a clinical history of handling sheep, goats, or other associated animals during one of the 6 clinical stages in a classic area. […] After a week of incubation, the lesions of orf can develop, progressing through 6 stages, each about a week in duration, as below: Maculopapular stage: Erythematous macules/papules, Target stage: Targetoid nodules surrounded by a red halo and necrotic center, Acute stage: Nodules begin to weep, Regenerative stage: Nodule becomes dry, Papilloma stage: Nodule has a dry crust and becomes papillomatous, Regression stage: Lesion begins to regress.

• #17 About Orf Virus (Sore Mouth Disease) | Orf | CDC

  https://www.cdc.gov/orf-virus/about/index.html

  People get painful sores and also sometimes have a fever or other symptoms. […] People infected with orf virus usually get sores or nodules on their hands or forearms. This rash is infectious, meaning it can spread to areas of a person’s body if they scratch or touch the sores. The sores progress through stages over six weeks. They may also have mild fever, tiredness or swelling of the glands in their neck and underarms (lymph nodes). […] People with weakened immune systems can develop more serious symptoms if they get infected with orf virus. They may have multiple sores or large tumor-like sores. They may also develop a second type of rash that isn’t infectious (called erythema multiforme).

• #18 Orf

  https://www.nhs.uk/conditions/orf/

  Orf is a skin infection you can get from infected sheep or goats. It most often affects the fingers, hands, forearms or face. It usually clears up without treatment in about 6 weeks. […] Orf usually affects the skin on your fingers, hands, forearms or face. A circular, purple mark on the middle finger of a person with white skin. The mark is slightly smaller than their fingernail. To start with, the affected area of skin is small and may look a reddish-blue colour. It may be itchy or tender. […] Over a few weeks, the affected area of skin gets bigger and turns into a blister. The blister is usually 2 to 3cm, but it can grow up to 5cm. It may leak fluid before crusting over. […] Other symptoms of orf include a high temperature, general tiredness (fatigue), swollen glands on the inside of your elbow or under your arm.

• #19 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #20

  https://zana.com/a/orf-symptoms-orf.7069

  In humans, the first sign of orf is a small, red, itchy or painful lump (lesion) that usually appears on the fingers, hands, forearms or face after an incubation period of three to five days. In some cases there may be more than one lesion. […] The lesion will usually be firm, red or blue in colour and 2-5cm in diameter. […] As the condition progresses over a three- to six-week period, a pustule or blister that weeps fluid will develop on top and eventually crust over. […] Other possible symptoms include a mild fever (high temperature), general tiredness (fatigue) and enlarged lymph glands.

• #21 About Orf Virus (Sore Mouth Disease) | Orf | CDC

  https://www.cdc.gov/orf-virus/about/index.html

  People get painful sores and also sometimes have a fever or other symptoms. […] People infected with orf virus usually get sores or nodules on their hands or forearms. This rash is infectious, meaning it can spread to areas of a person’s body if they scratch or touch the sores. The sores progress through stages over six weeks. They may also have mild fever, tiredness or swelling of the glands in their neck and underarms (lymph nodes). […] People with weakened immune systems can develop more serious symptoms if they get infected with orf virus. They may have multiple sores or large tumor-like sores. They may also develop a second type of rash that isn’t infectious (called erythema multiforme).

• #22

  https://dermnetnz.org/topics/orf

  Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. […] After an incubation period of 56 days, a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 23 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. […] Red streaks up the lymph channels (lymphangitis) with enlargement of the lymph glands on the inner side of the elbow and/or under the arm (lymphadenopathy) are not uncommon. There may be a mild fever. […] Patients who are immune deficient or immune suppressed may develop larger or unusual orf lesions. Rarely widespread small blisters may occur, suggesting blood stream spread of the orf virus, but resolve after a few weeks.

• #23

  https://dermnetnz.org/topics/orf

  Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. […] After an incubation period of 56 days, a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 23 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. […] Red streaks up the lymph channels (lymphangitis) with enlargement of the lymph glands on the inner side of the elbow and/or under the arm (lymphadenopathy) are not uncommon. There may be a mild fever. […] Patients who are immune deficient or immune suppressed may develop larger or unusual orf lesions. Rarely widespread small blisters may occur, suggesting blood stream spread of the orf virus, but resolve after a few weeks.

• #24 Orf: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1133450-overview

  Orf typically has a self-limited course with spontaneous resolution in 4-8 weeks after progressing through distinct stages. […] The prognosis of orf is excellent. The orf lesions usually heal completely with no scarring in about 35 days (4-8 wk). Scarring can occur if secondary infection or trauma to the lesion occurs. […] Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy, reduction of immunosuppression, and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment and required amputation. […] Mortality from orf has not been reported.

• #25 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  As a zoonotic infection, orf viral infection follows a relatively benign course. It typically resolves spontaneously within 6 to 12 weeks and has a very low rate of human-to-human spread. A more aggressive course with increased size (giant orf) may appear in immunocompromised hosts, especially those with cell-mediated immune deficiency. […] Secondary bacterial infections are possible complications of orf infection. Other complications can include lymphangitis, lymphadenopathy, and erysipelas.

• #26 Orf Virus in Humans: Case Series and Clinical Review | MDedge

  https://blogs.the-hospitalist.org/content/orf-virus-humans-case-series-and-clinical-review

  A patient presenting with a hand pustule is a phenomenon encountered worldwide requiring careful history-taking. […] Recognizing orf virus as the etiology of a cutaneous hand pustule in patients is important, as misdiagnosis can lead to unnecessary invasive testing and/or treatments with suboptimal clinical outcomes. […] Development of a nodule or papule on a patients hand with recent exposure to fomites or direct contact with a goat or sheep up to 1 week prior is extremely suggestive of an orf virus infection. […] Clinically, orf most often begins as an individual papule or nodule on the dorsal surface of the patients finger or hand and ranges from completely asymptomatic to pruritic or even painful. […] Ecthyma contagiosum is not a static disease but changes in appearance over the course of infection. Typically, lesions will appear 3 to 7 days after inoculation with the orf virus and will self-resolve 6 to 8 weeks later.

• #27 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  Orf viral infection, also known as ecthyma contagiosum or contagious pustular dermatitis, is an occupational disease primarily acquired from infected sheep and goats. […] Orf passes through 6 clinical stages and is usually diagnosed with a clinical history of handling sheep, goats, or other associated animals during one of the 6 clinical stages in a classic area. […] After a week of incubation, the lesions of orf can develop, progressing through 6 stages, each about a week in duration, as below: Maculopapular stage: Erythematous macules/papules, Target stage: Targetoid nodules surrounded by a red halo and necrotic center, Acute stage: Nodules begin to weep, Regenerative stage: Nodule becomes dry, Papilloma stage: Nodule has a dry crust and becomes papillomatous, Regression stage: Lesion begins to regress.

• #28 ORF – الجمعية السعودية لأمراض وجراحة الجلد

  https://ssdds.org/en/5221/

  Orf is a skin infection caused by parapox virus, a zoonotic contracted from goats and sheep. Because the condition causes crusts and scabs around the mouth, nose, teats, and other areas, it is also known as contagious pustular dermatitis. The disease lasts for roughly six weeks, and it is extremely contagious. […] The incubation period lasts from 5-6 days. Patients usually present with a 2-3 cm solitary small, firm, red lump that enlarges to form a flat-topped, blood-tinged pustule or blister on the forearms, hands, and fingers. Large lesions could be observed in immunocompromised individuals. Typically, making an incision through the skin will reveal firm, red tissue beneath, despite the appearance of pus from the skin. In the early stages, the orf lesion is frequently sensitive and irritating. Lymphangitis and lymphadenopathy of the inner side of the elbow and/or under the arm are not uncommon. These features could be associated with mild fever.

• #29 Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-08998-7

  EM has been related to Orf in 7-18% of patients, but mechanisms of Orf-induced autoimmune reactions are still unclear and systemic dissemination of the virus has not yet been proven. […] In immunocompetent individuals, ORF lesions often spontaneously resolve within a maximum of 8 weeks, as reported in our case study.

• #30 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. […] A lesion appears 3 to 7 days after contact with an infected animal and evolves slowly over the course of 4 to 8 weeks. It starts as a firm red painful papule that expands into a broad, thickened 1- to 3-cm lesion. The centre of the lesion is red and is surrounded by a white, raised ring with erythematous periphery. The crusting occurs and resolves by 3 to 6 weeks with little to no scarring.

• #31 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. […] A lesion appears 3 to 7 days after contact with an infected animal and evolves slowly over the course of 4 to 8 weeks. It starts as a firm red painful papule that expands into a broad, thickened 1- to 3-cm lesion. The centre of the lesion is red and is surrounded by a white, raised ring with erythematous periphery. The crusting occurs and resolves by 3 to 6 weeks with little to no scarring.

• #32 Orf: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1133450-overview

  Orf typically has a self-limited course with spontaneous resolution in 4-8 weeks after progressing through distinct stages. […] The prognosis of orf is excellent. The orf lesions usually heal completely with no scarring in about 35 days (4-8 wk). Scarring can occur if secondary infection or trauma to the lesion occurs. […] Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy, reduction of immunosuppression, and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment and required amputation. […] Mortality from orf has not been reported.

• #33 Orf Virus in Humans: Case Series and Clinical Review | MDedge

  https://blogs.the-hospitalist.org/content/orf-virus-humans-case-series-and-clinical-review

  Orf lesions have been described to progress through 6 distinct phases before resolving: maculopapular (erythematous macule or papule forms), targetoid (formation of a necrotic center with red outer halo), acute (lesion begins to weep), regenerative (lesion becomes dry), papilloma (dry crust becomes papillomatous), and regression (skin returns to normal appearance). […] Reports of systemic symptoms are uncommon but can include lymphadenopathy, fever, and malaise. […] Although the disease course in immunocompetent individuals is quite mild, immunocompromised patients may experience persistent orf lesions that are painful and can be much larger, with reports of several centimeters in diameter. […] Although lesions typically are asymptomatic in most patients, complications can occur, especially in immunosuppressed individuals. These complications include systemic symptoms, giant persistent lesions prone to infection or scarring, erysipelas, lymphadenitis, and erythema multiforme. […] Long-term prognosis is still good in these patients with appropriate disease recognition and treatment. Reinfection is not uncommon with repeated exposure to the source, but lesions are less severe and resolve faster than with initial infection.

• #34 What Is Orf Virus?

  https://www.webmd.com/a-to-z-guides/what-is-orf-virus

  As it progresses, the lesion will dry out, and you’ll notice tiny black spots forming on the surface. Finally, the lesion becomes flat, and a dry crust forms around it. At this point, the healing process begins. […] Though they are rare, complications can occur. You’re at a greater risk of complications if you’re immunocompromised due to conditions like HIV or chemotherapy treatments. Complications may include bacterial infection, a rash that looks like a bulls-eye target, or a skin condition known as bullous pemphigoid, which forms large blisters. […] Additionally, humans may develop some immunity to the orf virus after their initial infection, though subsequent infections can still occur. However, any following orf infections may present less severe symptoms.

• #35 Orf Virus in Humans: Case Series and Clinical Review | MDedge

  https://blogs.the-hospitalist.org/content/orf-virus-humans-case-series-and-clinical-review

  Orf lesions have been described to progress through 6 distinct phases before resolving: maculopapular (erythematous macule or papule forms), targetoid (formation of a necrotic center with red outer halo), acute (lesion begins to weep), regenerative (lesion becomes dry), papilloma (dry crust becomes papillomatous), and regression (skin returns to normal appearance). […] Reports of systemic symptoms are uncommon but can include lymphadenopathy, fever, and malaise. […] Although the disease course in immunocompetent individuals is quite mild, immunocompromised patients may experience persistent orf lesions that are painful and can be much larger, with reports of several centimeters in diameter. […] Although lesions typically are asymptomatic in most patients, complications can occur, especially in immunosuppressed individuals. These complications include systemic symptoms, giant persistent lesions prone to infection or scarring, erysipelas, lymphadenitis, and erythema multiforme. […] Long-term prognosis is still good in these patients with appropriate disease recognition and treatment. Reinfection is not uncommon with repeated exposure to the source, but lesions are less severe and resolve faster than with initial infection.

• #36 Orf

  https://www.nhs.uk/conditions/orf/

  The blister on your skin should clear up in around 6 weeks. Cover it with a waterproof dressing to keep it clean and dry and stop it getting infected. […] Orf can affect some people more severely than others. Your risk of getting complications is higher if you have a weakened immune system for example, by having a condition like HIV, or a treatment like chemotherapy. Possible complications include a bacterial infection, a rash that looks like a target or „bulls-eye” (erythema multiforme), a skin condition that can cause large blisters (bullous pemphigoid).

• #37 Human Orf with Immune-Mediated Reactions: A Systematic Review

  https://www.mdpi.com/2076-2607/11/5/1138

  Moreover, persistent or more aggressive forms of disease, such as large highly vascularized tumor-like skin lesions, can exceptionally present in immunocompromised patients, especially those with T cell dysfunction. […] Potential complications may occur, including secondary bacterial infections, lymphadenopathy, lymphangitis, and secondary immunological manifestations such as erythema multiforme (EM), widespread papulovesicular eruption, Stevens–Johnson syndrome, or antibody-mediated hypersensitivity reactions such as blistering disorders. […] The most frequently reported immunological complication (7–18%) is EM, a self-limited acute condition with a wide spectrum of severity. […] The diagnosis in humans is usually based on the anamnesis and the clinical features. […] However, because of the extensive clinical differential diagnosis of primary lesions and secondary immunological reactions, as well as the unfamiliarity of many physicians with this disease, especially in areas where it is uncommon, currently Orf is under-recognized, often leading to delayed diagnosis and inappropriate treatments.

• #38 Orf Viral Infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562191/

  As a zoonotic infection, orf viral infection follows a relatively benign course. It typically resolves spontaneously within 6 to 12 weeks and has a very low rate of human-to-human spread. A more aggressive course with increased size (giant orf) may appear in immunocompromised hosts, especially those with cell-mediated immune deficiency. […] Secondary bacterial infections are possible complications of orf infection. Other complications can include lymphangitis, lymphadenopathy, and erysipelas.

• #39 Orf: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1133450-overview

  Orf typically has a self-limited course with spontaneous resolution in 4-8 weeks after progressing through distinct stages. […] The prognosis of orf is excellent. The orf lesions usually heal completely with no scarring in about 35 days (4-8 wk). Scarring can occur if secondary infection or trauma to the lesion occurs. […] Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy, reduction of immunosuppression, and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment and required amputation. […] Mortality from orf has not been reported.

• #40 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Human orf is a benign infection and its diagnosis can be based on clinical findings to avoid unnecessary expensive testing and invasive treatment. The disease is self-limiting and clears without treatment within several weeks. Surgical debridement should be avoided because it can lead to scarring and prolong the recovery period. The lesion should be kept clean with antiseptic solution to avoid a secondary bacterial infection.

• #41 Human Orf with Immune-Mediated Reactions: A Systematic Review

  https://www.mdpi.com/2076-2607/11/5/1138

  Orf is a highly contagious zoonosis caused by Orf virus (ORFV), which is endemic in sheep and goats worldwide. Human Orf is usually a self-limiting disease, but potential complications, including immune-mediated reactions, may occur. […] The prevailing immunological reaction was erythema multiforme (26, 59.1%), followed by bullous pemphigoid (7, 15.9%). […] Orf-related immune reactions can have a varied clinical presentation, and it is important for clinicians to be aware of this in order to make a prompt diagnosis. […] Approximately 3 to 7 days after inoculation, infection in humans usually presents as a single papule or nodule on the hands or fingers, evolving through six different stages until spontaneous resolution in approximately 6–8 weeks. […] Multiple lesions may also occur.

• #42

  https://dermnetnz.org/topics/orf

  Erythema multiforme, a secondary rash to the presence of the orf virus, may develop 1014 days after the onset of orf. It results in targetoid macules, plaques and blisters on the hands and feet, face, arms and legs. Less distinctive red rashes, 'toxic erythemas’ also occur, and rarely the blistering disorder, pemphigoid.

• #43 Human Orf with Immune-Mediated Reactions: A Systematic Review

  https://www.mdpi.com/2076-2607/11/5/1138

  Moreover, persistent or more aggressive forms of disease, such as large highly vascularized tumor-like skin lesions, can exceptionally present in immunocompromised patients, especially those with T cell dysfunction. […] Potential complications may occur, including secondary bacterial infections, lymphadenopathy, lymphangitis, and secondary immunological manifestations such as erythema multiforme (EM), widespread papulovesicular eruption, Stevens–Johnson syndrome, or antibody-mediated hypersensitivity reactions such as blistering disorders. […] The most frequently reported immunological complication (7–18%) is EM, a self-limited acute condition with a wide spectrum of severity. […] The diagnosis in humans is usually based on the anamnesis and the clinical features. […] However, because of the extensive clinical differential diagnosis of primary lesions and secondary immunological reactions, as well as the unfamiliarity of many physicians with this disease, especially in areas where it is uncommon, currently Orf is under-recognized, often leading to delayed diagnosis and inappropriate treatments.

• #44 Orf

  https://www.nhs.uk/conditions/orf/

  The blister on your skin should clear up in around 6 weeks. Cover it with a waterproof dressing to keep it clean and dry and stop it getting infected. […] Orf can affect some people more severely than others. Your risk of getting complications is higher if you have a weakened immune system for example, by having a condition like HIV, or a treatment like chemotherapy. Possible complications include a bacterial infection, a rash that looks like a target or „bulls-eye” (erythema multiforme), a skin condition that can cause large blisters (bullous pemphigoid).

• #45 What Is Orf Virus?

  https://www.webmd.com/a-to-z-guides/what-is-orf-virus

  As it progresses, the lesion will dry out, and you’ll notice tiny black spots forming on the surface. Finally, the lesion becomes flat, and a dry crust forms around it. At this point, the healing process begins. […] Though they are rare, complications can occur. You’re at a greater risk of complications if you’re immunocompromised due to conditions like HIV or chemotherapy treatments. Complications may include bacterial infection, a rash that looks like a bulls-eye target, or a skin condition known as bullous pemphigoid, which forms large blisters. […] Additionally, humans may develop some immunity to the orf virus after their initial infection, though subsequent infections can still occur. However, any following orf infections may present less severe symptoms.

• #46

  https://dermnetnz.org/topics/orf

  Erythema multiforme, a secondary rash to the presence of the orf virus, may develop 1014 days after the onset of orf. It results in targetoid macules, plaques and blisters on the hands and feet, face, arms and legs. Less distinctive red rashes, 'toxic erythemas’ also occur, and rarely the blistering disorder, pemphigoid.

• #47

  https://dermnetnz.org/topics/orf

  Erythema multiforme, a secondary rash to the presence of the orf virus, may develop 1014 days after the onset of orf. It results in targetoid macules, plaques and blisters on the hands and feet, face, arms and legs. Less distinctive red rashes, 'toxic erythemas’ also occur, and rarely the blistering disorder, pemphigoid.

• #48 Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-08998-7

  Orf virus (ORFV) is the pathogen responsible for Orf, a zoonotic viral infection that can be spread to humans from sheep and goats. […] A 51-year-old woman with no previous medical history presented with a one-week history of three asymptomatic swelling nodules with a grey necrotic center and red outer halo on her index finger. At physical examination there was also a pruritic papulovesicular eruption on her hands and feet. […] The lesions spontaneously resolved within the next 2 weeks. […] Human infection typically manifests as a single papule or nodule 3 to 7 days after inoculation. It progresses through 6 stages before spontaneous remission occurs 6 to 8 weeks later. […] Current studies suggest that ORFV can cause a variety of hypersensitivity reactions being erythema multiforme (EM) the most common immunological consequence recorded, which typically appears before the primary lesions have completely healed and generally 3 weeks following the onset of Orf.

• #49 About Orf Virus (Sore Mouth Disease) | Orf | CDC

  https://www.cdc.gov/orf-virus/about/index.html

  People get painful sores and also sometimes have a fever or other symptoms. […] People infected with orf virus usually get sores or nodules on their hands or forearms. This rash is infectious, meaning it can spread to areas of a person’s body if they scratch or touch the sores. The sores progress through stages over six weeks. They may also have mild fever, tiredness or swelling of the glands in their neck and underarms (lymph nodes). […] People with weakened immune systems can develop more serious symptoms if they get infected with orf virus. They may have multiple sores or large tumor-like sores. They may also develop a second type of rash that isn’t infectious (called erythema multiforme).

• #50 Human Orf with Immune-Mediated Reactions: A Systematic Review

  https://www.mdpi.com/2076-2607/11/5/1138

  Moreover, persistent or more aggressive forms of disease, such as large highly vascularized tumor-like skin lesions, can exceptionally present in immunocompromised patients, especially those with T cell dysfunction. […] Potential complications may occur, including secondary bacterial infections, lymphadenopathy, lymphangitis, and secondary immunological manifestations such as erythema multiforme (EM), widespread papulovesicular eruption, Stevens–Johnson syndrome, or antibody-mediated hypersensitivity reactions such as blistering disorders. […] The most frequently reported immunological complication (7–18%) is EM, a self-limited acute condition with a wide spectrum of severity. […] The diagnosis in humans is usually based on the anamnesis and the clinical features. […] However, because of the extensive clinical differential diagnosis of primary lesions and secondary immunological reactions, as well as the unfamiliarity of many physicians with this disease, especially in areas where it is uncommon, currently Orf is under-recognized, often leading to delayed diagnosis and inappropriate treatments.

• #51 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #52 Unusual Presentation of Orf in an Otherwise Healthy Individual | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0399

  Giant orf has been reported primarily in immunosuppressed individuals, but a few cases have been seen in otherwise healthy individuals. […] In addition, in our patient the orf virus infection was associated with concurrent skin trauma, which is a well-known facilitating factor for orf infection. […] As this case demonstrates, orf can easily be misdiagnosed.

• #53 Orf: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1133450-overview

  Orf typically has a self-limited course with spontaneous resolution in 4-8 weeks after progressing through distinct stages. […] The prognosis of orf is excellent. The orf lesions usually heal completely with no scarring in about 35 days (4-8 wk). Scarring can occur if secondary infection or trauma to the lesion occurs. […] Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy, reduction of immunosuppression, and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment and required amputation. […] Mortality from orf has not been reported.

• #54

  https://dermnetnz.org/topics/orf

  Orf lesions are generally solitary or few in number. They occur most commonly on the fingers, hands or forearms but can appear on the face. […] After an incubation period of 56 days, a small, firm, red or reddish-blue lump enlarges to form a flat-topped, blood-tinged pustule or blister. The fully developed lesion is usually 23 cm in diameter but may be as large as 5 cm. Characteristically, although there appears to be pus under the white skin, incising this will reveal firm, red tissue underneath. The orf lesion is sometimes irritable during the early stages and is often tender. […] Red streaks up the lymph channels (lymphangitis) with enlargement of the lymph glands on the inner side of the elbow and/or under the arm (lymphadenopathy) are not uncommon. There may be a mild fever. […] Patients who are immune deficient or immune suppressed may develop larger or unusual orf lesions. Rarely widespread small blisters may occur, suggesting blood stream spread of the orf virus, but resolve after a few weeks.

• #55 Orf (disease) – Wikipedia

  https://en.wikipedia.org/wiki/Orf_(disease)

  Orf is a farmyard pox, a type of zoonosis. It causes small pustules in the skin of primarily sheep and goats, but can also occur on the hands of humans. A pale halo forms around a red centre. It may persist for several weeks before crusting and then either resolves or leaves a granuloma. There is usually only one non-painful lesion, but there can be more. Lymph nodes may also become swollen. […] While orf is usually a benign self-limiting illness which resolves in 3-6 weeks, in the immunocompromised it can be very progressive and even life-threatening. One percent topical cidofovir has been successfully used in a few patients with progressive disease. Serious damage may be inflicted on the eye if it is infected by orf, even among otherwise healthy patients. […] More typically, sheep will become free of orf within a week or so as the disease runs its course.

• #56 Orf Virus in Animals | Orf | CDC

  https://www.cdc.gov/orf-virus/about/orf-virus-in-animals.html

  Orf virus infection occurs worldwide in sheep and goats and sometimes other animals with hooves. Often called Sore Mouth Disease, the infection causes sores on animals’ mouths and other areas. Sheep and goats may get sores on their lower legs and teats, especially when female animals are nursing infected young. When infected with orf virus: […] Animals almost always recover completely within a month. Some breeds, especially Boer goats, may be more likely to get sore mouth infection. These breeds may also have more severe illnesses if they get infected. Animals can get infected multiple times during their lives. Repeat infections usually occur after at least a year and are generally less severe. If your animal(s) have sores and more severe symptoms like extra saliva or becoming lame, report it right away.

• #57 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Orf is a highly contagious eruptive skin condition of sheep and goats, but various other ruminants and mammals have been reported to be infected as well. It affects mainly young animals in the first year of their life and the more serious outbreaks are generally associated with intensive sheep husbandry. […] The orf virus primarily affects the skin around the mouth, and under normal circumstances is resolved in 4 to 6 weeks. However, lesions may become extensive and spread to other parts of the body, and can be transmitted to the ewes udder causing her to refuse to suckle. The lesions on the udder may cause acute staphylococcal ewe mastitis and starvation of the lambs. […] Orf is a contagious virus that usually causes scabs and lesions in the mouth and gums of the infected animal. It mainly affects animals in the first year of their life, however, infected lambs can transmit the virus to the ewes udders while suckling.

• #58 Contagious Ecthyma in Sheep and Goats – Integumentary System – Merck Veterinary Manual

  https://www.merckvetmanual.com/integumentary-system/pox-diseases/contagious-ecthyma-in-sheep-and-goats

  Contagious ecthyma is an infectious dermatitis of sheep and goats that primarily affects the lips of young animals. The disease is typically more severe in goats than in sheep. Treatment usually focuses on secondary infections. Affected animals go off feed, fail to gain weight, and may develop serious secondary infections at the lesion sites, all of which result in production losses. […] The primary lesion of contagious ecthyma develops at the mucocutaneous junction of the lips and around erupting incisor teeth, and it may extend to the mucosa of the buccal cavity. The lesions develop as papules and progress through vesicular and pustular stages before encrusting. Coalescence of numerous discrete lesions often leads to the formation of large scabs, and the proliferation of dermal tissue produces a verrucose mass under them.

• #59 Scabby mouth (orf) | Sheep diseases | Animal diseases | Biosecurity | Agriculture Victoria

  https://agriculture.vic.gov.au/biosecurity/animal-diseases/sheep-diseases/scabby-mouth-orf

  Scabby mouth (contagious ecthyma, orf) is a highly contagious, viral disease of sheep, goats and occasionally humans. […] The mouth and feet are most affected. At first small, reddened areas appear and begin to weep a clear fluid. This fluid eventually hardens into a thick brown scab. In the early stages the scab is firmly attached and if forcibly removed, a raw bleeding area is exposed. […] After two to three weeks the scabs dry up and drop off. The underlying skin then heals rapidly. […] In most cases the scabs appear at the corner of the mouth and muzzle. In severe cases they cover the lips and spread into the mouth and nostrils. […] Scabs can also develop on the udder and teats of ewes. Affected ewes may not allow lambs to suckle resulting in lamb losses and reduced weight gain. Affected lambs may find it difficult to feed or suckle normally.

• #60 Scabby mouth (orf) | Sheep diseases | Animal diseases | Biosecurity | Agriculture Victoria

  https://agriculture.vic.gov.au/biosecurity/animal-diseases/sheep-diseases/scabby-mouth-orf

  Scabby mouth (contagious ecthyma, orf) is a highly contagious, viral disease of sheep, goats and occasionally humans. […] The mouth and feet are most affected. At first small, reddened areas appear and begin to weep a clear fluid. This fluid eventually hardens into a thick brown scab. In the early stages the scab is firmly attached and if forcibly removed, a raw bleeding area is exposed. […] After two to three weeks the scabs dry up and drop off. The underlying skin then heals rapidly. […] In most cases the scabs appear at the corner of the mouth and muzzle. In severe cases they cover the lips and spread into the mouth and nostrils. […] Scabs can also develop on the udder and teats of ewes. Affected ewes may not allow lambs to suckle resulting in lamb losses and reduced weight gain. Affected lambs may find it difficult to feed or suckle normally.

• #61 Orf Virus in Animals | Orf | CDC

  https://www.cdc.gov/orf-virus/about/orf-virus-in-animals.html

  Orf virus infection occurs worldwide in sheep and goats and sometimes other animals with hooves. Often called Sore Mouth Disease, the infection causes sores on animals’ mouths and other areas. Sheep and goats may get sores on their lower legs and teats, especially when female animals are nursing infected young. When infected with orf virus: […] Animals almost always recover completely within a month. Some breeds, especially Boer goats, may be more likely to get sore mouth infection. These breeds may also have more severe illnesses if they get infected. Animals can get infected multiple times during their lives. Repeat infections usually occur after at least a year and are generally less severe. If your animal(s) have sores and more severe symptoms like extra saliva or becoming lame, report it right away.

• #62 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Orf is characterized by the appearance of scabby lesions on the lips and nostrils. These may spread to the gums, palate and tongue, and severely affected lambs may be unable to feed for several days, becoming debilitated and prone to other diseases. The ewes udder may also become affected, causing her to refuse to suckle. This may have serious repercussions, resulting in mastitis in the ewe and starvation of the lamb. […] Lesions on other body parts may become susceptible to secondary bacterial invasion, resulting in prolonged disease and even death.

• #63 Scabby mouth (orf) | Sheep diseases | Animal diseases | Biosecurity | Agriculture Victoria

  https://agriculture.vic.gov.au/biosecurity/animal-diseases/sheep-diseases/scabby-mouth-orf

  The disease in sheep and goats is normally self-limiting and clears without treatment within 3 to 4 weeks. […] Early manual removal of scabs will delay healing. […] Animals that recover from scabby mouth develop a lifelong immunity to the disease. Sheep of all ages may become affected during the first outbreak on the property, but in subsequent years usually only the lambs are affected. […] Humans occasionally become infected with the scabby mouth virus. The disease in humans is called orf. The usual signs in humans are red papules, which are most often on the hands or arms.

• #64 Orf (Contagious Ecthyma)

  https://www.tamuk.edu/finance/risk/animal-safety/orf.html

  Orf, also known as contagious ecthyma, sore mouth, contagious pustular dermatitis or scabby mouth, is a pox-like viral disease of sheep and goats. The disease is characterized by scabs and pustules on the face (muzzle, lips, inside the mouth and around the eyes), on the feet and occasionally on the udder. Orf can be occasionally be transmitted to humans. […] Most human infection consists of painful sores on the hands or fingers which can last for up to 2 months. People with weakened immune systems may have a more serious infection if exposed to orf. […] In Animals: The disease takes 2-14 days to develop after exposure to the virus. Pox-like skin lesions in sheep and goats are usually found on the lips, but may be found on the nose, eyelids, ears, oral cavity, udder, wounds, skin at the top of the hoof or skin between the hoof claws.

• #65 Scabby mouth (orf) | Sheep diseases | Animal diseases | Biosecurity | Agriculture Victoria

  https://agriculture.vic.gov.au/biosecurity/animal-diseases/sheep-diseases/scabby-mouth-orf

  Scabby mouth (contagious ecthyma, orf) is a highly contagious, viral disease of sheep, goats and occasionally humans. […] The mouth and feet are most affected. At first small, reddened areas appear and begin to weep a clear fluid. This fluid eventually hardens into a thick brown scab. In the early stages the scab is firmly attached and if forcibly removed, a raw bleeding area is exposed. […] After two to three weeks the scabs dry up and drop off. The underlying skin then heals rapidly. […] In most cases the scabs appear at the corner of the mouth and muzzle. In severe cases they cover the lips and spread into the mouth and nostrils. […] Scabs can also develop on the udder and teats of ewes. Affected ewes may not allow lambs to suckle resulting in lamb losses and reduced weight gain. Affected lambs may find it difficult to feed or suckle normally.

• #66 Orf Virus in Animals | Orf | CDC

  https://www.cdc.gov/orf-virus/about/orf-virus-in-animals.html

  Orf virus infection occurs worldwide in sheep and goats and sometimes other animals with hooves. Often called Sore Mouth Disease, the infection causes sores on animals’ mouths and other areas. Sheep and goats may get sores on their lower legs and teats, especially when female animals are nursing infected young. When infected with orf virus: […] Animals almost always recover completely within a month. Some breeds, especially Boer goats, may be more likely to get sore mouth infection. These breeds may also have more severe illnesses if they get infected. Animals can get infected multiple times during their lives. Repeat infections usually occur after at least a year and are generally less severe. If your animal(s) have sores and more severe symptoms like extra saliva or becoming lame, report it right away.

• #67

  http://www.veterinaryhandbook.com.au/Diseases.aspx?diseasenameid=250

  Scabby mouth is a highly contagious viral disease that affects the skin of sheep and goats. It is caused by the orf virus, a member of the genus Parapoxvirus. […] Mainly young animals are affected, as older animals will have recovered from earlier infection. […] Reddened areas with clear, sticky exudates or hard brown scabs seen on the skin of sheep and goats, especially around the lips and nostrils, is probably scabby mouth. Coalescing of lesions can result in scabs covering a much larger area. As the disease progresses, the scab becomes a dry, cracked crust. Weight loss can be rapid if lips are swollen or the mucosa of the mouth is affected, however, most cases show few systemic clinical signs. […] Lesions will spontaneously regress over 3-4 weeks, but may persist for longer if there is secondary bacterial infection.

• #68 Orf Virus in Animals | Orf | CDC

  https://www.cdc.gov/orf-virus/about/orf-virus-in-animals.html

  Orf virus infection occurs worldwide in sheep and goats and sometimes other animals with hooves. Often called Sore Mouth Disease, the infection causes sores on animals’ mouths and other areas. Sheep and goats may get sores on their lower legs and teats, especially when female animals are nursing infected young. When infected with orf virus: […] Animals almost always recover completely within a month. Some breeds, especially Boer goats, may be more likely to get sore mouth infection. These breeds may also have more severe illnesses if they get infected. Animals can get infected multiple times during their lives. Repeat infections usually occur after at least a year and are generally less severe. If your animal(s) have sores and more severe symptoms like extra saliva or becoming lame, report it right away.

• #69 Contagious Ecthyma | Zoonotic Virus Affects Sheep and Goats

  https://www.tvmf.org/articles/contagious-ecthyma-orf/

  Orf first appears as blisters on the lips, muzzle and in the mouth. These blisters soon develop into crusty scabs. Lesions can also spread to the lower legs and teats, especially in ewes or does that are nursing infected young. […] Infection typically lasts for three to four weeks, and, except in very rare cases, affected animals completely recover. Most animals develop only mild signs, though some, particularly younger animals, may stop eating and drinking due to pain. These animals may have difficulty nursing and will need to be supplemented with bottle or tube feeding. Nursing ewes or does may reject their young as well due to the pain associated with suckling. Older animals that develop severe clinical signs will also need additional nutritional support. […] Repeat infections do occur, though they usually develop more than a year after the previous infection and have less severe clinical signs.

• #70 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Severely affected young lambs may be unable to eat for days, becoming debilitated and prone to secondary bacterial infection of the lesion which may lead to prolonged disease or even death. […] Infection spreads rapidly through the flock, with most animals becoming infected within a few weeks. Outbreaks can be particularly severe in housed sheep due to the high stocking rate. […] Outbreaks usually last for between 6 and 8 weeks, and generally do not reappear until there is a fresh crop of susceptible lambs. […] Sheep that have recovered from infection have only limited protection against reinfection, although subsequent infections tend to be milder and more short-lived than the initial one. […] Orf can affect sheep of all ages and has serious welfare implications. It causes scabs and lesions usually in the mouth area, but can affect udders and feet as well.

• #71 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Orf is characterized by the appearance of scabby lesions on the lips and nostrils. These may spread to the gums, palate and tongue, and severely affected lambs may be unable to feed for several days, becoming debilitated and prone to other diseases. The ewes udder may also become affected, causing her to refuse to suckle. This may have serious repercussions, resulting in mastitis in the ewe and starvation of the lamb. […] Lesions on other body parts may become susceptible to secondary bacterial invasion, resulting in prolonged disease and even death.

• #72 Contagious Ecthyma in Sheep and Goats – Integumentary System – Merck Veterinary Manual

  https://www.merckvetmanual.com/integumentary-system/pox-diseases/contagious-ecthyma-in-sheep-and-goats

  Contagious ecthyma is an infectious dermatitis of sheep and goats that primarily affects the lips of young animals. The disease is typically more severe in goats than in sheep. Treatment usually focuses on secondary infections. Affected animals go off feed, fail to gain weight, and may develop serious secondary infections at the lesion sites, all of which result in production losses. […] The primary lesion of contagious ecthyma develops at the mucocutaneous junction of the lips and around erupting incisor teeth, and it may extend to the mucosa of the buccal cavity. The lesions develop as papules and progress through vesicular and pustular stages before encrusting. Coalescence of numerous discrete lesions often leads to the formation of large scabs, and the proliferation of dermal tissue produces a verrucose mass under them.

• #73 Contagious Ecthyma in Sheep and Goats – Integumentary System – Merck Veterinary Manual

  https://www.merckvetmanual.com/integumentary-system/pox-diseases/contagious-ecthyma-in-sheep-and-goats

  During the course of the disease (14 weeks), the scabs drop off and the tissues heal without scarring. During active stages of infection, more severely affected lambs do not eat normally, and they lose condition. Extensive lesions on the feet result in lameness. Mastitis, sometimes gangrenous, may occur in ewes with lesions on the teats.

• #74 Farm Health Online – Animal Health and Welfare Knowledge Hub – Orf

  https://www.farmhealthonline.com/US/disease-management/sheep-diseases/orf/

  Severely affected young lambs may be unable to eat for days, becoming debilitated and prone to secondary bacterial infection of the lesion which may lead to prolonged disease or even death. […] Infection spreads rapidly through the flock, with most animals becoming infected within a few weeks. Outbreaks can be particularly severe in housed sheep due to the high stocking rate. […] Outbreaks usually last for between 6 and 8 weeks, and generally do not reappear until there is a fresh crop of susceptible lambs. […] Sheep that have recovered from infection have only limited protection against reinfection, although subsequent infections tend to be milder and more short-lived than the initial one. […] Orf can affect sheep of all ages and has serious welfare implications. It causes scabs and lesions usually in the mouth area, but can affect udders and feet as well.

• #75 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #76 Human orf

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5638474/

  Orf is one of the most widespread viral diseases worldwide and is caused by Parapoxvirus. It can be transmitted to humans from goats, deer, sheep, and cattle. Orf (also known as ecthyma contagiosum) can be transmitted to people who have direct contact with infected animals and it manifests as a erythematous maculopapular lesion. Human orf is usually self-limiting and no specific treatment is needed. […] A lesion appears 3 to 7 days after contact with an infected animal and evolves slowly over the course of 4 to 8 weeks. It starts as a firm red painful papule that expands into a broad, thickened 1- to 3-cm lesion. The centre of the lesion is red and is surrounded by a white, raised ring with erythematous periphery. The crusting occurs and resolves by 3 to 6 weeks with little to no scarring.

• #77 Orf Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1133450-clinical

  Orf occurs in humans with an occupational or household exposure to the virus via infected animals or fomites. The hands are where 95% of cases occur. Involvement of the face, scalp, and genital regions have been reported. The lesions may be pruritic and are generally painless. If the lesions are painful, then secondary infection should be suspected. With orf, a low-grade fever may occur but usually subsides within 3-4 days. Systemic symptoms such as lymphadenopathy, erysipelaslike lesions, and erythema multiforme can occur in up to one third of cases. Large, fungating orf lesions or multiple lesions have been reported in patients who are immunosuppressed, burn patients, atopic dermatitis patients, and one patient with scleroderma. […] Orf appears as a solitary lesion or as a few lesions on the fingers, hands, or forearms, and orf has even been reported on the face, scalp, and groin. The orf lesion starts as a small, firm, red-to-blue papule then progresses through a series of 6 stages. The fully developed orf lesion is typically 2-3 cm in diameter, but it may reach 5 cm. After incubation of 3-7 days, the orf infection goes through six clinical stages, each lasting about 1 week, as follows: Stage 1 (maculopapular) – A red elevated lesion. Stage 2 (targetoid) – A bulla with an irislike configuration (nodule with a red center, a white middle ring, and a red periphery). Stage 3 (acute) – A weeping nodule. Stage 4 (regenerative) – A firm nodule covered by a thin crust through which black dots are seen. Stage 5 (papillomatous) – Small papillomas appearing over the surface. Stage 6 (regressive) – A thick dry crust covering the resolving lesion.

• #78 General Physician for Orf virus disease, Symptoms, Treatment | mfine

  https://www.mfine.co/general-physicians/conditions/orf-virus-disease/

  Orf virus disease, which is also known as scabby or sore mouth, is an infection, which causes lesions on the lips, ears, nostrils, and less commonly in the genitalia and on the feet of the infected animals. […] If you suffer from Orf virus infection, you may notice the following symptoms: […] – Formation of nodules on the fingers, hands, or the forearms. – Mild fever. – Malaise (fatigue). – Local swelling of the lymph nodes. […] Short-term: Can be resolved within 3 to 6 weeks.

• #79

  https://dermnetnz.org/topics/orf

  Erythema multiforme, a secondary rash to the presence of the orf virus, may develop 1014 days after the onset of orf. It results in targetoid macules, plaques and blisters on the hands and feet, face, arms and legs. Less distinctive red rashes, 'toxic erythemas’ also occur, and rarely the blistering disorder, pemphigoid.

• #80 Finger nodules with a papulovesicular hands and feet eruption: a complicated human Orf virus infection | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-08998-7

  EM has been related to Orf in 7-18% of patients, but mechanisms of Orf-induced autoimmune reactions are still unclear and systemic dissemination of the virus has not yet been proven. […] In immunocompetent individuals, ORF lesions often spontaneously resolve within a maximum of 8 weeks, as reported in our case study.

• #81 Orf: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1133450-overview

  Orf typically has a self-limited course with spontaneous resolution in 4-8 weeks after progressing through distinct stages. […] The prognosis of orf is excellent. The orf lesions usually heal completely with no scarring in about 35 days (4-8 wk). Scarring can occur if secondary infection or trauma to the lesion occurs. […] Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy, reduction of immunosuppression, and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment and required amputation. […] Mortality from orf has not been reported.

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