Erbağci Zülal, Erbağci Ibrahim, Almila Tuncel A
Department of Dermatology, Gaziantep University Medical Faculty, Turkey.
J Dermatolog Treat. 2005;16(5-6):353-6. doi: 10.1080/09546630500375734.
Orf is a zoonosis caused by an epitheliotropic DNA parapox virus. Human orf is a generally benign, self-limiting condition that usually regresses in 6-8 weeks without specific treatment. However, it may be accompanied by local symptoms including pain, pruritus, lymphangitis and axillary adenitis, or less frequently by systemic symptoms such as fever or malaise. Furthermore, it may be complicated by erythema multiforme, Stevens-Johnson syndrome, erysipelas, generalized mucocutaneous eruption, toxic erythema, eyelid oedema and giant, persistent or recurrent lesions in immunocompromised patients. Imiquimod, a potent topical immune response modifier, enhances both the innate and acquired immunity by stimulation of immune system cells resulting in local antiviral, antitumour and immunoregulatory activity. We present, for the first time, four complicated cases of orf successfully treated by topical imiquimod resulting in rapid regression of both orf and associated lesions. Two of the cases were complicated with erythema multiforme, one with recurrent eyelid oedema, and another had giant orf associated with axillary lymphadenitis. We suggest that topical imiquimod may be an effective and safe therapy for complicated orf cases.
羊痘疮是一种由嗜上皮性DNA副痘病毒引起的人畜共患病。人类羊痘疮通常是一种良性的自限性疾病，通常在6 - 8周内自行消退，无需特殊治疗。然而，它可能伴有局部症状，包括疼痛、瘙痒、淋巴管炎和腋窝淋巴结炎，或较少见的全身症状，如发热或不适。此外，它可能并发多形红斑、史蒂文斯-约翰逊综合征、丹毒、全身性黏膜皮肤疹、中毒性红斑、眼睑水肿，以及免疫功能低下患者出现的巨大、持续性或复发性病变。咪喹莫特是一种有效的局部免疫反应调节剂，通过刺激免疫系统细胞增强先天免疫和后天免疫，从而产生局部抗病毒、抗肿瘤和免疫调节活性。我们首次报告了4例经局部使用咪喹莫特成功治疗的复杂羊痘疮病例，羊痘疮及相关病变均迅速消退。其中2例并发多形红斑，1例反复出现眼睑水肿，另1例有与腋窝淋巴结炎相关的巨大羊痘疮。我们认为局部使用咪喹莫特可能是治疗复杂羊痘疮病例的一种有效且安全的疗法。
