A 19 year-old Caucasian male shepherd, with no relevant medical history, presented to the Emergency Department of our hospital complaining about a necrotic lesion at the dorsal surface of his left hand (Fig. 1A). He mentioned that he had noticed similar lesions located at the lips and the breasts of his sheep (Fig. 1B). The diagnosis of Orf disease was clinically established, based on the typical presentation and the positive history of exposure. No special treatment was given to the patient, apart from local antiseptics, resulting in complete regression of the lesions within a month period. He was strongly advised to wear gloves when handling his animals and practice proper hand hygiene. Orf (or Contagious Ecthyma) is a zoonotic disease, caused by a parapoxvirus and mainly affects sheep and goats,1 but it can be transmitted to humans through direct contact with infected animals.2 It is generally considered as a self-limited clinical entity. However, successful treatment of complicated cases with topical use of imiquimod3 or cidofovir cream4 has been described in the literature.

Fig. 1.

(A) Orf lesions located at the patient's hand and (B) at the breasts of his sheep.

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