Orf with unusual features

We describe a case of Orf in an immunocompetent man with no history of direct contact with farm animals. The patient presented with numerous large lesions on hands and feet including a lesion in the subungual area. Later on multiple lesions with more bizarre morphology developed on the trunk. The diagnosis was suspected on clinical appearance of the lesion and confirmed later by histopathology. We consider contact with contaminated soil as the possible source of infection as virus can survive in pastures. Awareness of unusual clinical patterns of known entities is important to avoid unnecessary interventions.