Milker's nodules: classic histological findings

Abstract

Milker's nodule is an occupational dermatovirose caused by Parapoxvirus, which is self-limited and, due to the lack of information of health professionals, may lead to underdiagnosis. We present two cases with exuberant manifestations and classic histopathologic findings. Case 1: Male, 19 years of age, milker, presented nodules and blisters on his palm for 15 days. Case 2: Male, 33 years of age, administrative assistant, presented erythematous nodules on his palms with lymphangitis for 5 days. He had milked a cow one week before the onset of the lesions. In both cases, the histopathology was representative and coincident with the clinical hypothesis. The lesions have presented complete involution. Milker's nodule diagnosis is based on clinical presentation, epidemiology, and histopathology. The knowledge of this disease is essential for its correct diagnosis, as well as to guide the implementation of public health measures and the appropriate treatment of sick cattle.

Pockenvirusinfektionen in der Dermatologie

“…252,253 Die histopathologische Untersuchung erlaubt keine Unterscheidung zwischen verschiedenen Gattungen von Pockenviren. 254 Die Elektronenmikroskopie, welche in Speziallaboratorien verfügbar ist, kann zum Nachweis einer Infektion mit Parapoxviren hilfreich sein, da sie im Gegensatz zu den ziegelsteinförmigen Pockenviruspartikeln aller anderen Gattungen eine besondere Kokonform und eine waffelartige Oberfläche aufweisen. 5,251 Prävention Die Vermeidung von Risikokontakten beugt einer Infektion vor.…”

Enhancing diagnostic accuracy in common human poxvirus infections during mpox outbreak: A dermoscopy review

“…Milker's nodule (also known as pseudocowpox) is caused by the Milker's nodule virus (Paravaccinia virus) infection, Paravaccinia virus is a DNA virus belonging to the Parapoxvirus Genus, which can be transmitted from infected cattle, cattle by-products or fomites to the human, mostly, human infection with the Milker's nodule virus is an occupational incident. 36,[43][44][45][46] Compared with Orf, both the Orf and Milker's nodules display nearly identical clinical and histopathologic features, which are caused by a different virus but from the same Parapoxvirus genus. 43 Although clinical features were like Orf, the history of acquisition from contact with cows rather than sheep or goats can be helpful for distinguishing the milker's nodule and Orf, also clinical and dermoscopic features were similar to Orf, and no significant dermoscopic differences have been determined between both.…”

“…Milker's nodule (also known as pseudocowpox) is caused by the Milker's nodule virus (Paravaccinia virus) infection, Paravaccinia virus is a DNA virus belonging to the Parapoxvirus Genus, which can be transmitted from infected cattle, cattle by‐products or fomites to the human, mostly, human infection with the Milker's nodule virus is an occupational incident 36,43–46 . Compared with Orf, both the Orf and Milker's nodules display nearly identical clinical and histopathologic features, which are caused by a different virus but from the same Parapoxvirus genus 43 .…”

Poxvirus infections in dermatology – the neglected, the notable, and the notorious

“…252,253 Histopathological examination will not allow to differentiate between different genera of poxviruses. 254 Electron microscopy may only be available in specialized laboratories but can be instrumental to detect parapoxvirus infection for their particular cocoon-shape and wafer-like surface as opposed to brick-shaped poxvirus particles of all other genera. 5,251 Prevention Primarily, avoidance of risk contacts prevents infection.…”