Orf

  • Author: Lana H Hawayek, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: May 28, 2013
 

Background

Orf is a viral disease that is widespread in sheep and goats. Orf can be transmitted to humans by contact with an infected animal or contaminated fomites. Reindeer have also caused similar lesions in humans. Orf is frequently seen in farming communities[1, 2] and meat handlers. Clinically, reddish weeping nodules of orf are seen on the dorsa of the hands and the fingers that heal spontaneously in approximately 35 days. See the image below.

An early lesion of orf (papular stage). An early lesion of orf (papular stage).
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Pathophysiology

Orf is primarily a disease involving the skin, though the lymph nodes are occasionally involved.

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Epidemiology

Frequency

International

A higher frequency of orf reports has occurred from Europe and New Zealand compared with North America, but this is of unknown significance.

Mortality/Morbidity

The natural course of orf is spontaneous recovery in 3-6 weeks.

  • Immunocompromised patients with orf can have progressive, destructive lesions requiring medical interventions such as antiviral therapy and surgical debridement. However, reports exist of immunosuppressed individuals with large, fungating lesions that have been refractory to treatment.
  • Mortality from orf has not been reported.

Race

Orf has been reported exclusively in whites.

Sex

No sexual predilection is reported for orf.

Age

No age predilection is described for orf.

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Contributor Information and Disclosures
Author

Lana H Hawayek, MD Assistant Professor of Dermatology, Cosmetic Dermatologic Surgery and Laser Specialist, University of Cincinnati, Veterans Affairs Medical Center; Consulting Staff, University Dermatology Consultants

Lana H Hawayek, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Nelly Rubeiz, MD Consulting Staff, Department of Dermatology, American University of Beirut Medical Center; Professor, Department of Dermatology, American University of Beirut, Lebanon

Nelly Rubeiz, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Shyam Verma, MBBS DVD, FAAD, Clinical Associate Professor, Department of Dermatology, University of Virginia; Adjunct Associate Professor, Department of Dermatology, State University of New York at Stonybrook, Adjunct Associate Professor, Department of Dermatology, University of Pennsylvania

Shyam Verma, MBBS is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  2. Paiba GA, Thomas DR, Morgan KL, Bennett M, Salmon RL, Chalmers R, et al. Orf (contagious pustular dermatitis) in farmworkers: prevalence and risk factors in three areas of England. Vet Rec. 1999 Jul 3. 145(1):7-11. [Medline].

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  15. De Clercq E. Clinical potential of the acyclic nucleoside phosphonates cidofovir, adefovir, and tenofovir in treatment of DNA virus and retrovirus infections. Clin Microbiol Rev. 2003 Oct. 16(4):569-96. [Medline].

  16. Shelley WB, Shelley ED. Surgical treatment of farmyard pox. Orf, milker's nodules, bovine papular stomatitis pox. Cutis. 1983 Feb. 31(2):191-2. [Medline].

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  25. Deane D, McInnes CJ, Percival A, Wood A, Thomson J, Lear A, et al. Orf virus encodes a novel secreted protein inhibitor of granulocyte-macrophage colony-stimulating factor and interleukin-2. J Virol. 2000 Feb. 74(3):1313-20. [Medline].

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  31. Yirrell DL, Vestey JP, Norval M. Immune responses of patients to orf virus infection. Br J Dermatol. 1994 Apr. 130(4):438-43. [Medline].

 
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An early lesion of orf (papular stage).
The target phase associated with edema.
A classic location of orf on the index finger.
The regenerative stage of orf with a central crust.
Orf lesion (arrow) associated with erythema multiforme.
 
 
 
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