Description, Causes and Risk Factors:
Ecthyma contagious is an endemic zoonotic viral disease which occasionally transmitted to man. Ecthyma contagious results from infection by the virus, a member of the genus Parapoxvirus in the family Poxviridae.
Ecthyma contagious has been found worldwide in all countries that raise sheep. In the U.S., this disease is seen most often in the Western states.
In humans, ecthyma contagious usually occurs as a single skin lesion or a few lesions. The initial lesion is a small, firm, red to blue papule at the site of virus penetration, most often a finger, hand or other exposed part of the body. The papule develops into a hemorrhagic pustule or bulla, which may contain a central crust and bleeds easily. In the later stages, the lesion develops into a nodule, which may weep fluid and is sometimes covered by a thin crust. It eventually becomes covered by a thick crust. The skin lesions may be accompanied by a low grade fever that usually lasts only a few days, or by mild lymphadenopathy. In uncomplicated disease, the lesion heals spontaneously in 3 to 6 weeks without scarring. Secondary infections can occur. Large lesions refractory to treatment can occur in people who are immunosuppressed. Unusually large lesions have also been reported in people with atopic dermatitis. Rare cases involving the eye, as well as a generalized vesiculopapular rash on the skin and mucosa, have also been reported. Possible complications include toxic erythema, erythema multiforme and bullous pemphigoid.
Although ecthyma contagious usually resolves spontaneously and the mortality rate is generally low, fatality rates up to 10% have been reported. Most infections in humans are localized and heal spontaneously; however, large, poorly healing lesions can occur in people who are immunosuppressed.
The virus produces characteristic localized raised vesicular lesions which passthrough predictable sequence of evolution.Secondary bacterial infections can occur and, in rare cases, the lesions may extend into the internal organs.
Ecthyma contagious can be confirmed by electron microscopy of the crust, a small biopsy or fluid from the lesion; however, this technique cannot distinguish from other parapoxviruses. Polymerase chain reaction (PCR) assays can give a definitive diagnosis. Histopathology can also be helpful. Virus isolation can be attempted but the virus grows slowly and cannot always be isolated. Animal inoculation into lambs has been reported. Serology and the detection of viral antigens can be used in research, but are not ordinarily used for diagnosis.
In immunocompetent humans, ecthyma contagious is usually self-limiting. Treatment is supportive and typically consists of moist dressings, local antiseptics, finger immobilization and/or antibiotics to treat secondary bacterial infections. Large lesions can be removed by surgery, and curettage and electrodesiccation may be used for persistent lesions. Cryotherapy has been reported to hasten recovery.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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