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The Etiology of Milker's Nodules

The Etiology of Milker's Nodules Abstract Milkers' nodules is a self-limited, inflammatory disease which is characterized by the appearance of nodules on the exposed skin surfaces of persons who milk cows. Important features in a consideration of the etiology of the disease will be presented in this report in the following order:(1) historical note; (2) clinical and epidemiological features of milkers' nodules which suggest its etiology; (3) relationship of milkers' nodules to vaccinia; (4) attempts to transmit milkers' nodules experimentally; (5) comment, and (6) summary and conclusions. 1. Historical Note A. Spurious (or False) Cowpox.—The writings of Edward Jenner suggests that the disease which is now called milkers' nodules was either identical with or included in the disorder (or disorders) which Jenner called spurious cowpox. Jenner discussed the subject of spurious cowpox in four of his major writings and in several letters to his contemporaries.7,16 References 1. We have seen milkers' nodules in Michigan. 2. It is presumed by the authors that vaccinia and cowpox are either identical or closely related disorders, and in this discussion the term vaccinia includes cowpox. 3. It is interesting that Jenner thought spurious cowpox more prevalent when the cows were put to pasture. 4. This may not be the proper interpretation of this fact because it may be that the milkers who do not contract the disease have been rendered immune by previous exposure. 5. See Sultzberger's discussion of paper by Nomland and McKee.22 6. Beck, J. R.: Milker's Nodules: A Clinical Note , Delaware M. J. 12:180 ( (Aug.) ) 1940. 7. Becker, F. T.: Milkers' Nodules: Report of 4 Cases , J. A. M. A. 115:2140 ( (Dec. 21) ) 1940.Crossref 8. Becker, F. T.: Personal communication to the authors. 9. Bonnevie, P.: "Milker's Warts": Infection from "False Cowpox" with a Paravaccinia Virus , Brit. J. Dermat. 49:164 ( (April) ) 1937.Crossref 10. Brants, J.: Über einen Fall von Melkerknoten , Arch. Dermat. u. Syph. 178:87 ( (Aug.) ) 1938.Crossref 11. Cawley, E. P.; Whitmore, C. W., and Wheeler, C. E.: Milkers' Nodules , South. M. J. 46:21 ( (Jan.) ) 1953.Crossref 12. Crookshank, E. M.: Vaccination, Its History arid Pathology , Philadelphia, P. Blakiston and Co., 1889, Vol. 1, pp. 145, 146, and 154; Vol. 2, pp. 9, 160-163, 198-200, and 271-272. 13. Fasquelle, R.; de Graciansky, P.; Boulle, S.; Dilion, J., and Agasse, P.: Tubercle (ou nodule) de trayeurs , Bull. Soc. franç. dermat. et syph. 58:481 ( (Nov.) -Dec.) 1951. 14. Findlay, G. H., and Haig, D. A.: Milker's Nodules: Growth of the Virus in Developing Hen Eggs , Brit. J. Dermat. 64:451 ( (Dec.) ) 1952.Crossref 15. Frieboes, W.: Über sogenannte Melkerknoten (Kuhpockeninfektion) , Dermat. Ztschr. 21:310, 1914.Crossref 16. Garrison, S. C., Jr., and Adams, C. E.: Milkers' Nodules , J. Tennessee M. A. 46:420 ( (Nov.) ) 1953. 17. Green, M. T.: Milker's Nodule , New Orleans M. & S. J. 97:13 ( (July) ) 1944. 18. Groth, A.: Zur Aetiologie der Melkerknoten , München. med. Wchnschr. 76:2128 ( (Dec. 20) ) 1929. 19. Hester, H. R.; Boley, L. E., and Graham, R.: Studies on Cowpox: I. An Outbreak of Natural Cowpox and Its Relation to Vaccinia , Cornell Vet. 31:360 ( (Oct.) ) 1941. 20. Henry, A., and Bory, L.: Les vaccinoïdes ou nodosités dites des trayeurs (à propos un cas observé chez un vétérinaire) , Bull. Soc. franç. dermat. et syph. 41:1884 ( (Dec.) ) 1934. 21. Jenner, E.: An Inquiry into the Causes and Effects of the Variolae Vaccinae , London, S. Low, 1798, p. 7. 22. Katzenellenbogen, I.: Beitrag zur Aetiologie der Melkerknoten , Acta dermat.venereol. 16:316 ( (Nov.) ) 1935. 23. Katzenellenbogen, I.: Studies on Milker's Nodules, Dermatologica (Basel) 105:69, 1952. 24. Lehmann, E.: Zum Krankheitsbild der Melkerknoten , Zentralbl. Chir. 57:1529 ( (June 21) ) 1930. 25. Lipschütz, B.: Paravaccine , in Handbuch der Haut und Geschlechtskrankheiten , edited by J. Jadassohn, Berlin, Springer-Verlag 1932, Vol. 2, pp. 80-84. 26. Nasemann, T., and Deubner, B.: Beitrag zur Virusätiologie des Melkerknotens , Hautarzt 4:210 ( (May) ) 1953. 27. Nomland, R., and McKee, A. P.: Milkers' Nodules: Report of 10 Cases , A. M. A. Arch. Dermat. & Syph. 65:663 ( (June) ) 1952. 28. Puntigam, F., and Orth, E.: Ein Beitrag zur Aetiologie der Melkerknoten , Wien. klin. Wchnschr. 63:540 ( (July 27) ) 1951. 29. Richter, R., and Kressmann, M.: Beobachtungen über das Vorkommen und die Symptomatologie der Melkerknoten , Arch. Dermat. u. Syph. 192:245, 1951. 30. Rowe, R. J.: Personal communication to the authors. 31. Salkan, P. M.: Zur Klinik der Epidemiologie und Ätiologie der Melkerknoten , Acta Dermat.-venereol. 14:342 ( (Nov.) ) 1933. 32. Schultze, W.; Seifried, O., and Schaaf, J.: Die Melkerknoten und ihre Aetiologie , Ztschr. Infektionskr., par Krankh. u. Hyg. d. Haustiere 31:295 ( (Sept. 10) ) 1927. 33. Sonck, C. E.: Milkers' Nodules with Allergic Secondary Eruptions , Acta allergol , 4:241, 1951.Crossref 34. Sonck, C. E., and Penttinen, K.: Milkers' Nodules Transmission to Man , Acta dermat.-venereol. 34:420, 1954. 35. Stark, A. M.; Tresenhausen, M. M.; Gozanskaja, N. M.; Skrosky, E. W.; Schastny, D. S., and Zuk, W. A.: Über die Pockenätiologie der sog. Melkerknoten , Arch. Dermat. u. Syph. 170:38, 1934.Crossref 36. Wallace, H. J.: A Note on Milker's Nodes , Brit. J. Dermat. 59:379 ( (Nov.) ) 1947.Crossref 37. Wheeler, C. E., and Cawley, E. P.: Milkers' Nodules, South, M. J., to be published. 38. Woringer, F.: Deux nouveaux cas de tubercules du trayeur , Bull. Soc. franç. dermat. et. syph. 41:197 ( (Feb.) ) 1934. 39. Zurukzoglu, S., and Kuske, E.: Beitrag zum Problem der Aetiologie der Melkerknoten , Acta dermat.-venereol. 19:569 ( (Nov.) ) 1938. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Dermatology American Medical Association

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American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
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0096-5359
DOI
10.1001/archderm.1957.01550140093015
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Abstract

Abstract Milkers' nodules is a self-limited, inflammatory disease which is characterized by the appearance of nodules on the exposed skin surfaces of persons who milk cows. Important features in a consideration of the etiology of the disease will be presented in this report in the following order:(1) historical note; (2) clinical and epidemiological features of milkers' nodules which suggest its etiology; (3) relationship of milkers' nodules to vaccinia; (4) attempts to transmit milkers' nodules experimentally; (5) comment, and (6) summary and conclusions. 1. Historical Note A. Spurious (or False) Cowpox.—The writings of Edward Jenner suggests that the disease which is now called milkers' nodules was either identical with or included in the disorder (or disorders) which Jenner called spurious cowpox. Jenner discussed the subject of spurious cowpox in four of his major writings and in several letters to his contemporaries.7,16 References 1. We have seen milkers' nodules in Michigan. 2. It is presumed by the authors that vaccinia and cowpox are either identical or closely related disorders, and in this discussion the term vaccinia includes cowpox. 3. It is interesting that Jenner thought spurious cowpox more prevalent when the cows were put to pasture. 4. This may not be the proper interpretation of this fact because it may be that the milkers who do not contract the disease have been rendered immune by previous exposure. 5. See Sultzberger's discussion of paper by Nomland and McKee.22 6. Beck, J. R.: Milker's Nodules: A Clinical Note , Delaware M. J. 12:180 ( (Aug.) ) 1940. 7. Becker, F. T.: Milkers' Nodules: Report of 4 Cases , J. A. M. A. 115:2140 ( (Dec. 21) ) 1940.Crossref 8. Becker, F. T.: Personal communication to the authors. 9. Bonnevie, P.: "Milker's Warts": Infection from "False Cowpox" with a Paravaccinia Virus , Brit. J. Dermat. 49:164 ( (April) ) 1937.Crossref 10. Brants, J.: Über einen Fall von Melkerknoten , Arch. Dermat. u. Syph. 178:87 ( (Aug.) ) 1938.Crossref 11. Cawley, E. P.; Whitmore, C. W., and Wheeler, C. E.: Milkers' Nodules , South. M. J. 46:21 ( (Jan.) ) 1953.Crossref 12. Crookshank, E. M.: Vaccination, Its History arid Pathology , Philadelphia, P. Blakiston and Co., 1889, Vol. 1, pp. 145, 146, and 154; Vol. 2, pp. 9, 160-163, 198-200, and 271-272. 13. Fasquelle, R.; de Graciansky, P.; Boulle, S.; Dilion, J., and Agasse, P.: Tubercle (ou nodule) de trayeurs , Bull. Soc. franç. dermat. et syph. 58:481 ( (Nov.) -Dec.) 1951. 14. Findlay, G. H., and Haig, D. A.: Milker's Nodules: Growth of the Virus in Developing Hen Eggs , Brit. J. Dermat. 64:451 ( (Dec.) ) 1952.Crossref 15. Frieboes, W.: Über sogenannte Melkerknoten (Kuhpockeninfektion) , Dermat. Ztschr. 21:310, 1914.Crossref 16. Garrison, S. C., Jr., and Adams, C. E.: Milkers' Nodules , J. Tennessee M. A. 46:420 ( (Nov.) ) 1953. 17. Green, M. T.: Milker's Nodule , New Orleans M. & S. J. 97:13 ( (July) ) 1944. 18. Groth, A.: Zur Aetiologie der Melkerknoten , München. med. Wchnschr. 76:2128 ( (Dec. 20) ) 1929. 19. Hester, H. R.; Boley, L. E., and Graham, R.: Studies on Cowpox: I. An Outbreak of Natural Cowpox and Its Relation to Vaccinia , Cornell Vet. 31:360 ( (Oct.) ) 1941. 20. Henry, A., and Bory, L.: Les vaccinoïdes ou nodosités dites des trayeurs (à propos un cas observé chez un vétérinaire) , Bull. Soc. franç. dermat. et syph. 41:1884 ( (Dec.) ) 1934. 21. Jenner, E.: An Inquiry into the Causes and Effects of the Variolae Vaccinae , London, S. Low, 1798, p. 7. 22. Katzenellenbogen, I.: Beitrag zur Aetiologie der Melkerknoten , Acta dermat.venereol. 16:316 ( (Nov.) ) 1935. 23. Katzenellenbogen, I.: Studies on Milker's Nodules, Dermatologica (Basel) 105:69, 1952. 24. Lehmann, E.: Zum Krankheitsbild der Melkerknoten , Zentralbl. Chir. 57:1529 ( (June 21) ) 1930. 25. Lipschütz, B.: Paravaccine , in Handbuch der Haut und Geschlechtskrankheiten , edited by J. Jadassohn, Berlin, Springer-Verlag 1932, Vol. 2, pp. 80-84. 26. Nasemann, T., and Deubner, B.: Beitrag zur Virusätiologie des Melkerknotens , Hautarzt 4:210 ( (May) ) 1953. 27. Nomland, R., and McKee, A. P.: Milkers' Nodules: Report of 10 Cases , A. M. A. Arch. Dermat. & Syph. 65:663 ( (June) ) 1952. 28. Puntigam, F., and Orth, E.: Ein Beitrag zur Aetiologie der Melkerknoten , Wien. klin. Wchnschr. 63:540 ( (July 27) ) 1951. 29. Richter, R., and Kressmann, M.: Beobachtungen über das Vorkommen und die Symptomatologie der Melkerknoten , Arch. Dermat. u. Syph. 192:245, 1951. 30. Rowe, R. J.: Personal communication to the authors. 31. Salkan, P. M.: Zur Klinik der Epidemiologie und Ätiologie der Melkerknoten , Acta Dermat.-venereol. 14:342 ( (Nov.) ) 1933. 32. Schultze, W.; Seifried, O., and Schaaf, J.: Die Melkerknoten und ihre Aetiologie , Ztschr. Infektionskr., par Krankh. u. Hyg. d. Haustiere 31:295 ( (Sept. 10) ) 1927. 33. Sonck, C. E.: Milkers' Nodules with Allergic Secondary Eruptions , Acta allergol , 4:241, 1951.Crossref 34. Sonck, C. E., and Penttinen, K.: Milkers' Nodules Transmission to Man , Acta dermat.-venereol. 34:420, 1954. 35. Stark, A. M.; Tresenhausen, M. M.; Gozanskaja, N. M.; Skrosky, E. W.; Schastny, D. S., and Zuk, W. A.: Über die Pockenätiologie der sog. Melkerknoten , Arch. Dermat. u. Syph. 170:38, 1934.Crossref 36. Wallace, H. J.: A Note on Milker's Nodes , Brit. J. Dermat. 59:379 ( (Nov.) ) 1947.Crossref 37. Wheeler, C. E., and Cawley, E. P.: Milkers' Nodules, South, M. J., to be published. 38. Woringer, F.: Deux nouveaux cas de tubercules du trayeur , Bull. Soc. franç. dermat. et. syph. 41:197 ( (Feb.) ) 1934. 39. Zurukzoglu, S., and Kuske, E.: Beitrag zum Problem der Aetiologie der Melkerknoten , Acta dermat.-venereol. 19:569 ( (Nov.) ) 1938.

Journal

A.M.A. Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1957

References