Human monkeypox: cutaneous lesions in 8 patients in Canada

Most patients with human monkeypox (HMPX) have cutaneous lesions. In the 2022 outbreak of HMPX across nonendemic countries, cutaneous lesions have been different than previously described. In this outbreak, primary lesions often occur at anogenital and oral sites, suggesting direct inoculation, similar to patterns observed with syphilis. Primary lesions may occur before, with or without the onset of systemic symptoms. Although secondary lesions continue to present in a disseminated fashion, developmental pleomorphism, is seen more commonly than previous outbreaks in which lesions were classically monomorphic. Furthermore, new lesions can continue to emerge for several days. Here, Sukhdeo et al present clinical images to show the breadth of cutaneous and mucocutaneous lesions that presented in 8 patients with HMPX.