Abstract: All 5 patients were farmers engaged in long-term cattle slaughtering, trading, or dealing with cattle by-products, with an incubation period of 2-3 days. Cutaneous manifestations included the presence of painless, edematous, black escharotic lesions (1-3 cm in diameter) on exposed skin areas such as the hands, forearms, face, and neck, surrounded by small blisters and accompanied by localized tissue swelling and mild pruritus. Among them, Patients 1, 3, and 5 presented with fever; none of the patients exhibited respiratory, gastrointestinal, or neurological symptoms, nor did they show signs of sepsis. Physical examination revealed right axillary lymphadenopathy in Patient 5, and abdominal ultrasonography indicated splenomegaly in Patient 4. Chest computed tomography (CT) scans of all 5 patients showed no abnormalities, thus ruling out inhalational anthrax.Laboratory findings demonstrated positive results for Bacillus anthracis PCR nucleic acid tests in 2 cases, and positive results for colloidal gold-based serological antibody tests for cutaneous anthrax in 4 cases. All patients achieved full recovery following 20-24 days of treatment.

Key words: cutaneous anthrax, clinical manifestations, prophylaxis