Images in Clinical Medicine
Orf Skin Ulcer
N Engl J Med 1997; 337:1131October 16, 1997
- Article
Figure 1 A painful finger ulcer (Panel A) developed in a 58-year-old man who was also found to have a palpable olecranal lymph node. The rest of his examination was unremarkable. A biopsy specimen of the lesion, fixed and sectioned thinly for transmission electron microscopy, revealed numerous parapoxvirus particles. At a low magnification, extreme swelling of infected cells can be seen, resulting in degeneration (Panel B, ×6000). Higher magnification of a section of Panel B (see box) clearly shows characteristic oval virions consisting of a core (c) surrounded by an envelope (e) (Panel C, × 60,000). When questioned about risk factors for parapoxvirus infection, the patient reported contacts with sheep in a slaughterhouse. The parapoxvirus particles identified were presumed to be orf viruses, which cause a common skin disease of sheep and goats that is occasionally transmitted to humans.
Philippe Roingeard, Ph.D.
Laurent Machet, M.D.
Centre Hospitalier Universitaire, Tours 37044, France
