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Acute Onset of Erythematous Scalp Nodules in a Child—Diagnosis
Arch Dermatol. 2009;145(9):1053-1058.
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Diagnosis: Ecthyma contagiosum (orf) of the scalp.
MICROSCOPIC FINDINGS
Histologic examination of the biopsy specimen demonstrated ballooning degeneration of the epidermis and prominent granulation tissue and dense inflammatory infiltrate in the dermis. In addition to abundant bacterial colonization, necrotic keratinocytes and prominent crust consisting of intracellular, eosinophilic inclusion bodies were also identified.
DISCUSSION
The orf virus, from the Parapoxvirus genus, principally causes zoonotic infections in ruminants, such as sheep, goats, and reindeer. Humans are incidentally infected through occupational or recreational exposure like herding, butchering, or petting infected animals or herd animals recently vaccinated with live unattenuated virus. Children may be at elevated risk owing to less inhibited contact behaviors with animals as well as poor adherence to personal protective measures and hand hygiene.1 Our patient's guardian reported that 1 of the family's sheep—to which the patient was exposed—had a "sore mouth" about a month before the child's initial examination.
Orf commonly appears after inoculation of skin with impaired barrier function. . . . [Full Text of this Article]
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Arch Dermatol. 2009;145(9):1053-1058.
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