PMC6231385_01
(a) Erythematous-violaceous papules and an ulcerated violaceous nodule on the patient's (left) and her daughter's (right) fingers; (b) a violaceous erythematous lesion with red outer ring, and erythematous border on the right thumb of patient's daughter.
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fig1
On examination a central necrotic area (Figure 1(a)) was observed. Dermatology exam showed an indurated nodule with central umbilication covered by crust and surrounded by a reddish halo (Figure 1(b)).
Dermoscopy showed an erythematous area, central ulceration, yellow crust, brown dots, a white structureless zone partially surrounding it, and dotted vessels; original magnification x10 (DermLite II Pro 3Gen, San Juan Capistrano, CA, USA).
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fig2
Dermoscopy of the finger nodule showed an erythematous area, central ulceration, yellow crust, brown dots, a white structureless area partially surrounding the lesion, and dotted vessels (Figure 2).
(a) Udder lesions (arrow) on the patient's goat.
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Upon domiciliary visit to the patient's farm, goats with udder lesions (Figure 3(a)) were found.
Electron microscopy showing numerous viral particles (DNA core surrounded by double layered capsid) (red arrow). Insert: polymerase chain reaction (PCR) orf virus result. 2% agarose gel, with PCR product with ORF1/ORF2 primers, specific for orf virus; 140pb positive fragment (white circle); DNA ladder (100pb).
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fig4
In this case, it showed ovoid particles with a crisscross appearance due to viral particles (Figure 4); polymerase chain reaction was positive for the specific virus (ORFV) (Figure 4).
Patient feeding the kids using gloves.
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fig5
The patient was advised to feed the kids using gloves (Figure 5) and to commence local wound care for the lesions, because the disease was showing spontaneous regression.