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Correspondence |

Orf Acquired During Religious Observance

Mohsin Malik, MD; Michael Bharier, MD; Steven Tahan, MD; Leslie Robinson-Bostom, MD
Arch Dermatol. 2009;145(5):606-608. doi:10.1001/archdermatol.2009.69.
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Orf, also known as ecthyma contagiosum, is a cutaneous infection caused by a poxvirus (subgroup paravaccinia) typically transmitted to humans by contact with infected sheep and goats. Orf infection most commonly occurs in professional meat handlers and sheep herders, and so it is generally considered a result of occupational exposure.1 However, several reports from Belgium and Turkey describe orf transmission from animals handled during the Muslim observance of Eid-al-Adha (Feast of the Sacrifice).14 We describe herein a patient with, to our knowledge, the first case of orf acquired during a religious practice in the Western hemisphere.

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Figure 1.

A pink nodule with central crust, white outer ring, and erythematous border (scale indicates centimeters).

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Figure 2.

Histopathologic images from orf lesion. A, Low-power photomicrograph showing marked elongation of rete ridges and dense lymphohistiocytic infiltrate in intervening dermis (hematoxylin-eosin, original magnification ×40). B, Higher magnification reveals eosinophilic inclusions (arrow) within the vacuolated cytoplasm of upper epidermal keratinocytes characteristic of orf (hematoxylin-eosin, original magnification ×400).

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