Poxvirus‐induced angiogenesis after a thermal burn

Abstract

Orf (contagious ecthyma) is a zoonotic infection caused by a dermatotropic parapoxvirus that commonly infects sheep, goats, and oxen. Parapoxviruses are transmitted to humans through contact with an infected animal or fomites. Orf virus infections can induce ulceration, and papulonodular, pustular, or ecthymic lesions of the skin after contact with an infected animal or contaminated fomite. Rarely, orf virus provokes extensive vasculo-endothelial proliferation as a skin manifestation. Here, we present the case of an 8-year old female with poxvirus-induced vascular angiogenesis that developed 10 days after a thermal burn. An 8-year-old female presented at our outpatient clinic with red swellings and a yellow-brown crust on them. After a thermal burn with hot water, she went to a clinic and the burn was dressed with nitrofurazone and covered for 2 days. When the dressing was removed after 2 days, nodules were seen in the burnt areas. When the clinical findings were considered with the histopathological features, a reactive vascular proliferation due to a viral agent was suspected. Following PCR, parapoxvirus ovis was detected. Viral infections such as pox virus can trigger pyogenic granulomas or pyogenic granuloma-like vascular angiogenesis. Infectious agents must be considered when dealing with pyogenic granuloma-like lesions.

Unique Presentation of Orf Virus Infection in a Thermal-Burn Patient After Receiving an Autologous Skin Graft

“…Parapoxvirus infections are generally self-limiting; however, burn patients are uniquely at risk for complicated orf virus infections because of the breakdown of the epidermal barrier [13, 14]. In rare instances, lesions can be disseminated and have a complicated recovery compounded by secondary skin infections requiring medical intervention [13].…”

“…Although the occurrence may be rare, thermal-burn patients may be a unique category of patients at particular risk of acquiring various skin infections, such as orf virus infection [14]. Because of this patient’s unique orf virus infection at the site of the skin-graft harvest, we propose that, in addition to thermal-skin-burn patients, skin-graft donors and recipients may be at risk for orf virus infection, particularly if the donor site is not properly disinfected.…”

Human papilloma virus infection in the healing thermal-burn wound in a child

“…Macroscopic patterns vary between different HPV types and include atypical keloid‐like verruca, hepatic‐like lesions, and common warts . The histopathological characteristics of virus‐infected lesions in healing wounds vary between different HPV types.…”

Ecthyma contagiosum (Orf): Reflectance confocal microscopy and histopathological correlates

“…[2][3][4] After an incubation period of 3-10 days, the virus produces a local inflammatory response mediated by proteins homolog to vascular endothelial growth factor and IL-10. 5,6 Autoinoculation in different body areas and even human-to-human transmission are possible, especially in immunocompromised patients. 4 Typically, clinical appearance varies according to the evolution phase, ie, the maculopapular (red elevated lesion), the target (erythema multiforme-like), the regenerative (weeping nodule with crust), the papillomatous (with small papillomas appearing over the surface), and the regressive stage (a thick dry crust covering the resolving lesion).…”

“…Histopathologic examination was obtained from a punch biopsy in the internal edge of the ring (Figure 3 Turkey, Tunisia, France, Belgium, and Italy. [1][2][3][4][5][6][7][8]15 In the vast majority of patients, Orf lesions appeared days or weeks after the Muslim "Feast of Sacrifice" which celebrates the sacrifice asked of Abraham (Aid el Kebir) and occurs 2 months and 10 days after the end of Ramadan. 8,15 As per tradition, a man of the Muslim family uses to kill an alive lamb, being in contact with his blood.…”