Causes and risk factors
Milker’s nodule is caused due to infection with parapoxvirus, which infects the teats or udder of cows. Disease is transmitted to humans by infected lesions on the teats of cow or by objects contaminated with it. The disease is commonly seen in dairy farmers or vets.
Clinical presentation
Symptoms develop 5-14 days after the infection. Patient presents with small, red, raised, flat topped spots. These spots become blisters or lump, red-blue, firm within a week. Later, they develop into grayish skin and crust at the top. Lesions may be single or multiple. The lesions are commonly seen over hands, but may appear over face as well. Some lesions may have secondary bacterial infection. Patient may develop fever. There may be inflammation of the lymph channels (lymphadenitis), enlargement of lymph glands (lymphadenopathy). Erythema multiforme is seen after two weeks, after which the rash fades.
Investigations
Medical history by the patient and clinical examination by the dermatologist helps in diagnosis. Skin biopsy is required.
Treatment
Treatment is usually not required since the lesion fades within 5-7 weeks. Infected individual should wear gloves to prevent spread of infection. Antibiotics may be required to clear secondary bacterial infection, anti-inflammatory medicines, antipyretic may be required.
Complications
Complications such as secondary bacterial infection or abscesses can occur.
When to Contact a Doctor
As the disease is self-limiting, one must consult a doctor if there is secondary bacterial infection.
Prevention
Wearing gloves and taking precautionary antiseptic measures while handling the cattle, milking, washing them, etc., will prevent the disease. Isolation of infected animal helps in preventing transmission of disease to humans.
Systems involved
Integumentary system
Organs involved
Skin, lymph nodes
