Sleiay Mouhammed, Alqreea Mohammed, Alabdullah Hadi, Almohamed Ahmad, Alsmoudi Hasan, Al-Zahran Mulham, Katth Mouhammed Rabee, Sleiay Bilal
Faculty of Medicine, Hama University, Syria.
Aleppo Health Directorate, Leishmaniasis Centre, Aleppo, Syria.
Ann Med Surg (Lond). 2023 Dec 2;86(1):545-547. doi: 10.1097/MS9.0000000000001520. eCollection 2024 Jan.
Ecthyma contagiosum, sometimes referred to as human orf, is a zoonotic disease caused by the orf virus that is mostly acquired by coming into contact with diseased animals such as sheep or goats. The orf virus, a DNA virus belonging to the Poxviridae family, infects epidermal keratinocytes via breaking down the skin barrier, which can be caused by burns or wounds. The accompanying characteristic skin lesions can take on a range of morphologies depending on the infection's stage; lesions that are crusted, papillomatous, maculopapular, targetoid, and nodular can occur before clearing up. In addition to the lips and corners of the mouth, infected animals may also have lesions on the neck, vulva, and teeth. Skin sores caused by Ecthyma contagiousum discharge the orf virus into the environment.
A 4-month-old male infant with no medical history brought himself to the dermatology clinic with a minor fever and a skin lesion on his nose. An orf virus infection was discovered in the newborn through blood culture and PCR testing. For a subsequent infection, the patient received fusidic acid cream, an antibiotic, and an antipyretic. Following a follow-up of 3 months, the lesion vanished entirely.
Rarely, as in our instance, are orf nodules seen somewhere else than the hands. In order to appropriately treat a patient without fear, clinicians should keep this in mind, especially if they come up with a history similar to that of our patient.
传染性脓疱病，有时也称为人类羊痘疮，是一种由羊痘病毒引起的人畜共患病，主要通过接触患病动物如绵羊或山羊而感染。羊痘病毒是一种属于痘病毒科的DNA病毒，通过破坏皮肤屏障感染表皮角质形成细胞，皮肤屏障破坏可能由烧伤或伤口引起。伴随的特征性皮肤病变根据感染阶段可呈现多种形态；在消退前可能出现结痂、乳头瘤样、斑丘疹、靶样和结节状病变。除嘴唇和嘴角外，受感染动物的颈部、外阴和牙齿也可能出现病变。传染性脓疱病引起的皮肤溃疡会将羊痘病毒释放到环境中。
一名4个月大、无病史的男婴因低热和鼻子上的皮肤病变自行前往皮肤科诊所。通过血培养和PCR检测在新生儿中发现了羊痘病毒感染。对于后续感染，患者接受了夫西地酸乳膏、一种抗生素和一种退烧药治疗。经过3个月的随访，病变完全消失。
如我们的病例所示，羊痘结节很少出现在手部以外的其他部位。临床医生应牢记这一点，以便在不担心的情况下正确治疗患者，特别是如果他们遇到与我们患者类似的病史。
