[Three patients with orf (ecthyma contagiosum)]

Orf was diagnosed in three patients: a 16-year-old Moroccan girl who had cut her finger in a butcher's shop, a 47-year-old Dutch woman who had allowed a lamb to suck on her finger on a children's farm, and a 50-year-old Dutch farm woman. Orf or ecthyma contagiosum is a well-known viral disease among sheep and goats. Transmission to humans as a zoonosis is rare but can take place via direct contact with infected animals or animal products. The clinical picture is usually characterized by a solitary lesion that develops on the dorsal side of the fingers or hands. This viral condition produces little or no systemic complaints and the lesions usually regress spontaneously without scar formation within 6 weeks (range 4-9 weeks). The correct diagnosis can usually be made on clinical grounds. The diagnosis may be confirmed by demonstration of the virus by electron microscopy or the polymerase chain reaction in fluid obtained from the skin lesions or by conventional histopathology. Early clinical recognition and knowledge of this benign, self-limiting viral condition is vital to avoid unnecessary surgical intervention. Proper information and reassurance of the infected patient are very important. All three patients recovered.