Genital orf

TY - JOUR

T1 - Genital orf

AU - Thazhatheyil, Krishna

AU - Kourouni, Vasiliki

AU - Evans, Alan

AU - Mcmullan, Alexandra

N1 - Publisher Copyright: © BMJ Publishing Group Limited 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

PY - 2025/1/27

Y1 - 2025/1/27

N2 - A man in his early 40s presented with extensive skin lesions in the groin and genital regions. The lesions were erythematous and maculopapular but evolved into vesicles and pustules with surrounding cellulitis. He stated that he grips livestock between his legs for sheep shearing. Inflammatory markers were high, and skin swab cultures grew mixed bacteria. There was no evidence of necrotising soft tissue infection. Skin biopsy demonstrated irregularly acanthotic epidermis, striking reticular degeneration with intraepidermal oedema and surface necrosis. Keratinocytes displayed ballooning degeneration, with many showing vacuolation and eosinophilic cytoplasmic inclusions. There was no granulomatous infiltrate to suggest an atypical mycobacterial infection. Viral specimens sent for PCR confirmed orf virus infection. Though the treatment of orf is conservative, he was treated with parenteral antibiotics and topical antiseptics for secondary bacterial infection. Genital orf should be considered when clinically suggestive and eliciting detailed occupational and contact history is crucial in diagnosis.

AB - A man in his early 40s presented with extensive skin lesions in the groin and genital regions. The lesions were erythematous and maculopapular but evolved into vesicles and pustules with surrounding cellulitis. He stated that he grips livestock between his legs for sheep shearing. Inflammatory markers were high, and skin swab cultures grew mixed bacteria. There was no evidence of necrotising soft tissue infection. Skin biopsy demonstrated irregularly acanthotic epidermis, striking reticular degeneration with intraepidermal oedema and surface necrosis. Keratinocytes displayed ballooning degeneration, with many showing vacuolation and eosinophilic cytoplasmic inclusions. There was no granulomatous infiltrate to suggest an atypical mycobacterial infection. Viral specimens sent for PCR confirmed orf virus infection. Though the treatment of orf is conservative, he was treated with parenteral antibiotics and topical antiseptics for secondary bacterial infection. Genital orf should be considered when clinically suggestive and eliciting detailed occupational and contact history is crucial in diagnosis.

KW - Dermatological

KW - Dermatology

KW - General practice / family medicine

U2 - 10.1136/bcr-2024-261449

DO - 10.1136/bcr-2024-261449

M3 - Article

C2 - 39870466

AN - SCOPUS:85217189531

SN - 1757-790X

VL - 18

JO - BMJ Case Reports

JF - BMJ Case Reports

IS - 1

M1 - e261449

ER -