Since 1999, human infection caused by Orthopoxvirus has been observed in at least eight Brazilian states, with the presence of vesicles that evolve to pustules and crusts, especially on the hands, arms and face, after contact with cows showing comparable lesions on the udder. In addition to the skin lesions, there have been descriptions of patients with axillary ganglionic reactions that are sometimes painful, along with fever, headache, fatigue, dehydration, anorexia, sudoresis, arthralgia and muscle pain. The condition evolves over a three to four-week period. Vulvar lesions and transmission within families have also been described. Molecular studies have shown that the poxviruses identified are genetically related to vaccinia virus samples that were used in vaccination campaigns in the past. Clinical specimens from 80 human infections were studied in the laboratory, and orthopoxvirus infections were confirmed in 68 cases. The lesions observed in these patients are presented and the implications of this zoonosis in Brazil are discussed. Key-words:Orthopoxvirus. Vaccinia-like viruses. Human infections. Brazil.No Brasil, as campanhas de vacinação foram realizadas nas zonas rurais por equipes que se deslocavam de uma propriedade à outra, manipulando os frascos contendo a vacina viva com o vírus vaccinia em altos títulos, sendo comum a não eliminação adequada dos materiais residuais, contendo restos do imunizante. Admite-se que estes procedimentos permitiram a implantação de amostras do vírus vaccinia em ciclos naturais, pela infecção de animais reservatórios, como roedores silvestres, vindo a atingir posteriormente bovinos e pessoas que manejam estes animais. Um laboratório para o estudo destas infecções foi montado no Instituto Oswaldo Cruz, descrevendo-se neste artigo a experiência obtida no estudo de casos humanos ao longo dos últimos 10 anos.

The vulva corresponds to the external female genitalia. Special features of this region favor a wide range of diseases, whose knowledge allows for better clinical management, impacting on the quality of life. This is a cross-sectional and descriptive study carried out at a vulvar pathology outpatient clinic, between May and December/ 2015. Data obtained from a standard form included demographic parameters, habits, and vulvar dermatosis and allowed to identify the epidemiological profile of patients with vulvar dermatosis treated in this outpatient clinic and to determine the most prevalent dermatoses. Our results, partially concordant with the literature, provide original data that should stimulate further studies

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either “asymptomatic” or “much better” than before treatment and were “very satisfied” or “satisfied” with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.

In a dairy cattle farm, father and son developed successively a vesicopustular infection, with lesions in the hands and wrists, after contact with cows with vesicular lesions on the udder. After sexual contact with her husband, the mother showed a severe vesicular vulvar infection, which healed in about three weeks, leaving no scars. All family members showed high levels of antibodies in a plaque reduction neutralization test, using as antigen a locally isolated poxvirus strain, identified as a vaccinia-like virus by sequencing techniques. These data reconfirm that vaccinia-like viruses are circulating in Brazil and that person-to-person transmission may occur, without any relation to vaccinations against smallpox.