case_images: PMC6231385_01
case_images: (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.
case_images: CRIDM2018-2094086.001.jpg
case_images: PMC6231385_01_CRIDM2018-2094086.001.jpg
case_images: fig1
case_images: 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)).
case_images: 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).
case_images: CRIDM2018-2094086.002.jpg
case_images: PMC6231385_01_CRIDM2018-2094086.002.jpg
case_images: fig2
case_images: 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).
case_images: (a) Udder lesions (arrow) on the patient's goat.
case_images: CRIDM2018-2094086.003.jpg
case_images: PMC6231385_01_CRIDM2018-2094086.003.jpg
case_images: fig3
case_images: Upon domiciliary visit to the patient's farm, goats with udder lesions (Figure 3(a)) were found.
case_images: 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).
case_images: CRIDM2018-2094086.004.jpg
case_images: PMC6231385_01_CRIDM2018-2094086.004.jpg
case_images: fig4
case_images: 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).
case_images: Patient feeding the kids using gloves.
case_images: CRIDM2018-2094086.005.jpg
case_images: PMC6231385_01_CRIDM2018-2094086.005.jpg
case_images: fig5
case_images: 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.