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A dermatologic assessment of 101 mpox (monkeypox) cases from 13 countries during the 2022 outbreak: Skin lesion morphology, clinical course, and scarring.
Prasad, Sonya; Galvan Casas, Cristina; Strahan, Alexis G; Fuller, L Claire; Peebles, Klint; Carugno, Andrea; Leslie, Kieron S; Harp, Joanna L; Pumnea, Teodora; McMahon, Devon E; Rosenbach, Misha; Lubov, Janet E; Chen, Geoffrey; Fox, Lindy P; McMillen, Allen; Lim, Henry W; Stratigos, Alexander J; Cronin, Terrence A; Kaufmann, Mark D; Hruza, George J; French, Lars E; Freeman, Esther E.
  • Prasad S; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Icahn School of Medicine, The Mount Sinai Hospital, New York, New York.
  • Galvan Casas C; Department of Dermatology, University Hospital Mostoles, Madrid, Spain; Fundación Lluita contra les Infeccions, Hospital Germans Trias i Puyol, Badalona, Barcelona, Spain.
  • Strahan AG; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Mercer University School of Medicine, Savannah, Georgia.
  • Fuller LC; Chelsea and Westminster NHS Foundation Trust, London, UK; International Foundation for Dermatology, London, UK.
  • Peebles K; Department of Dermatology, Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland.
  • Carugno A; Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy; Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, Milan, Italy.
  • Leslie KS; Department of Dermatology, University of California San Francisco, San Francisco, California.
  • Harp JL; Department of Dermatology, Weill Cornell Medicine, New York, New York.
  • Pumnea T; Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany.
  • McMahon DE; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Rosenbach M; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Lubov JE; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Wright State University Boonshoft School of Medicine, Dayton, Ohio.
  • Chen G; Medical Practice Evaluation Foundation, Massachusetts General Hospital, Boston, Massachusetts.
  • Fox LP; Department of Dermatology, University of California San Francisco, San Francisco, California.
  • McMillen A; American Academy of Dermatology, Rosemont, Illinois.
  • Lim HW; Department of Dermatology, Henry Ford Health, Detroit, Michigan.
  • Stratigos AJ; First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece.
  • Cronin TA; Department of Dermatology and Cutaneous Surgery, University of Miami, Melbourne, Florida.
  • Kaufmann MD; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Hruza GJ; Department of Dermatology, Saint Louis University, Saint Louis, Missouri.
  • French LE; Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany; Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.
  • Freeman EE; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Medical Practice Evaluation Foundation, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: efreeman@mgh.harvard.edu.
J Am Acad Dermatol ; 88(5): 1066-1073, 2023 05.
Article in English | MEDLINE | ID: covidwho-2179883
ABSTRACT

BACKGROUND:

In the 2022 mpox (monkeypox) outbreak, 79,000 global cases have been reported. Yet, limited dermatologic data have been published regarding lesion morphology and progression.

OBJECTIVE:

The objective of this study was to characterize skin lesion morphology, symptomatology, and outcomes of mpox infection over time.

METHODS:

The American Academy of Dermatology/International League of Dermatological Societies Dermatology COVID-19, Mpox, and Emerging Infections Registry captured deidentified patient cases of mpox entered by health care professionals.

RESULTS:

From August 4 to November 13, 2022, 101 cases from 13 countries were entered, primarily by dermatologists (92%). Thirty-nine percent had fewer than 5 lesions. In 54% of cases, skin lesions were the first sign of infection. In the first 1-5 days of infection, papules (36%), vesicles (17%), and pustules (20%) predominated. By days 6-10, pustules (36%) were most common, followed by erosions/ulcers (27%) and crusts/scabs (24%). Crusts/scabs were the predominant morphology after day 11. Ten cases of morbilliform rash were reported. Scarring occurred in 13% of the cases.

LIMITATIONS:

Registry-reported data cannot address incidence. There is a potential reporting bias from the predilection to report cases with greater clinical severity.

DISCUSSION:

These findings highlight differences in skin findings compared to historical outbreaks, notably the presence of skin lesions prior to systemic symptoms and low overall lesion counts. Scarring emerged as a major possible sequela.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Diseases / Monkeypox / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Am Acad Dermatol Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Skin Diseases / Monkeypox / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Am Acad Dermatol Year: 2023 Document Type: Article