Milker's nodules

Last Updated: 2020-11-19

Author(s): Anzengruber F., Navarini A.

ICD11: -

Jenner 1798.

Paravacine nodes, milking pox.

Rare zoonosis of low infectivity caused by parapox virus.

  • Incubation period: 5-7 days.
  • Occurring on contact with cows.
  • Usually only the hands are affected.

Hemispherical, pea-sized, turgid, yellowish-brown knots with a blue-black tip. Locoregional lymphadenopathy.

Anamnesis, clinic, dermatopathology, electron microscopy (negative contrast), culture.

Vascular, epidermal granulation tissue with balloonized cells, multilocular vesicles.

  • Locally drying and antiseptic
  • e.g:


  • Iodine povidone (Betadine® solution.)
  • Application: Leave on for 2-3 minutes.
  • AI: Hyperthyroidism, M. Duhring, as part of radioiodotherapy.
  • According to the specialist information, pregnancy and lactation are also contraindications. In our opinion, the use of this method is also well justified.


  • Ruhigstellung der Finger 

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  3. Henriques AM, Fagulha T, Duarte M, et al. Avian Poxvirus Infection in a Flamingo (Phoenicopterus Ruber) of the Lisbon Zoo. J Zoo Wildl Med 2016;47:161-74. 
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  5. Novel poxvirus discovered in sea otters. J Am Vet Med Assoc 2014;245:265. 
  6. Werchniak AE, Herfort OP, Farrell TJ, Connolly KS, Baughman RD. Milker's nodule in a healthy young woman. Journal of the American Academy of Dermatology 2003;49:910-1.