Cutaneous Mpox: an epidemiological, clinical, diagnostic and therapeutic review of the dermatologic pandemic of the decade.

Abstract

INTRODUCTION: Mpox (formerly monkeypox), caused by the monkeypox virus (MPXV), has historically been confined to parts of Central and West Africa. However, recent outbreaks in non-endemic regions (2022-2024) revealed efficient transmission within sexual networks and a broad range of cutaneous and mucosal presentations. The aim of this review is to summarize key aspects of Mpox, including its epidemiology, pathogenesis, clinical features, diagnosis, treatment, and public health strategies for outbreak control. EVIDENCE ACQUISITION: A systematic literature search in PubMed until December 2024 was conducted using terms such as "monkeypox,", "mpox", "orthopoxvirus," and "skin lesions". Selected articles pertinent to dermatological clinical features, diagnostic methods, management, and prevention strategies were reviewed. EVIDENCE SYNTHESIS: While Mpox often presents with characteristic vesiculopustular lesions, the 2022 outbreak underscored frequent anogenital localization mimicking other sexually transmitted infections. Confirmatory testing via PCR remains essential, and supportive care suffices for most immunocompetent individuals. In severe or immunocompromised cases, antivirals like tecovirimat can shorten disease duration. Vaccination campaigns with Modified Vaccinia Ankara (MVA-BN) successfully reduced incidence in high-risk populations. Emerging evidence from Dermatology journals emphasizes atypical morphologies - hemorrhagic, necrotic, and bullous variants - in both immunocompetent and immunocompromised patients. CONCLUSIONS: Cutaneous Mpox presents diagnostic and therapeutic challenges for dermatologists and venereologists, particularly when lesions deviate from classical patterns. Continued research on vaccine durability, combination antiviral therapies, and long-term cutaneous sequelae will refine future outbreak responses and patient care.