Milkers' nodule virus infection and its resemblance to orf

ORF virus infection in children: clinical characteristics, transmission, diagnostic methods, and future therapeutics

Orf virus leads to self-limited, subacute cutaneous infections in children who have occupational or recreational contact with infected small ruminants. Breaches in the integument and contact with animals recently vaccinated for orf may be important risk factors in transmission. Common childhood behaviors are likely important factors in the provocation of significant contact (ie, bites) or in unusual lesion location (eg, facial lesions). Clinician recognition is important in distinguishing orf infection from life-threatening cutaneous zoonoses. Recently developed molecular techniques provide diagnostic precision and newer topical therapeutics may hasten healing.

Milker's nodule in a healthy young woman

Milker's nodules (pseudocowpox) are harmless skin lesions most commonly seen in persons whose occupation regularly brings them into close contact with cattle. They are caused by the paravaccinia virus, a member of the poxvirus family. Awareness of their clinical and histopathologic features is important, especially with today's heightened awareness of the threat of biologic warfare, to distinguish them from more worrisome entities such as tularemia and anthrax.