Other pox virus infections

The other pox infections are of incidental interest.

Cowpox only sporadically infects cows from its natural reservoir, probably small mammals, and may affect humans. Papules on the hands enlarge and develop necrosis and crusting.

Milkers' nodules are due to a virus that causes superficial ulcers in cows' udders and calves' mouths. In humans papules form on the hands and develop into grey nodules with a necrotic centre, surrounding inflammation, and lymphangitis. A more generalised papular eruption can occur.

Orf is often recognised in rural areas. It is seen mainly in early spring as a result of contact with lambs. A single papule or group of lesions develops on the fingers or hands with purple papules developing into bulla. This ruptures to leave an annular lesion 1-3 cm in diameter with a necrotic centre. There is surrounding inflammation. The incubation period is a few days and the lesions last two to three weeks with spontaneous healing. Associated erythema multiforme and widespread rashes are occasionally seen.

Cowpox, early stage
Milker's nodule
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