ABSTRACT
BACKGROUND: MPOX (Monkeypox) viral infection, a zoonotic disease previously confined to the African sub-continent, has caught attention worldwide recently due to its resurgence in a new 'avatar' among urban communities. Dermatologists in the U. A. E. started to see patients with fever and a self-limiting pustular necrotic rash that was negative for all other infectious investigations. METHODS: We performed a prospective observational multicenter clinical study of the demographics, skin manifestations, and outcomes of patients presenting with necrotic pustular lesions and/or fever. RESULTS: 35 cases of PCR confirmed MPOX cases, mostly in the expatriate population, were followed up and found to have high-risk heterosexual contact on an average of 1 week prior to disease onset. We found that they have characteristic annular pustular lesions with necrotic center or "Smoke ring pustules' in all cases. Lesion tenderness and predilection for the lower abdomen, pubic area, and genitalia were observed. Most cases were systemically stable, with fever lasting for an average of 4 days and elevated CRP levels. Genital lesions were prone to secondary bacterial infections. The disease was severe, with larger annular plaques in one of our patients found to be living with HIV. CONCLUSIONS: The overall prognosis in healthy individuals is good, with lesions healing within an average of 2 weeks without scarring. 'New world MPOX' should be unclassified from zoonosis to a sexually transmitted infection (STI) capable of transmission in an urban population. Our findings can help in early clinical suspicion and differentiation from other STI's for primary and secondary health care physicians.
ABSTRACT
BACKGROUND: Dermatological emergencies in children are not uncommon. Worldwide, limited studies have been done to study the spectrum of such emergencies. The aim of our study was to analyze the spectrum of dermatological emergencies in the pediatric age group. MATERIALS AND METHODS: Over a period of 18 months, ninety consecutive patients under 18 years of age presenting with cutaneous in addition to emergency disorders as assessed by the Nelson's severity scoring system were recruited. RESULTS: The most common emergency was primary cutaneous infections (40%), followed by adverse cutaneous drug reactions (13.33%). Staphylococcal scalded skin syndrome was the most frequent infection, and the most common adverse cutaneous drug reaction was Stevens-Johnson syndrome and toxic epidermal necrolysis. Other emergencies included purpura fulminans (12.22%), congenital dermatoses (11.11%), vasculitis (8.90%), angioedema (6.67%), collagen vascular diseases (2.22%), serum sickness (2.22%), post-varicella cerebellitis (1.11%), post-infected scabies glomerulonephritis (1.11%), and Langerhans cell histiocytosis (1.11%). These emergencies presented in equal numbers to the outpatient department of dermatology or pediatrics and to the emergency department. CONCLUSION: Our study recommends the use of standard scoring systems such as the Nelson's score to assess sick children. The appropriateness of this scale or other scales for the assessment of dermatological emergencies needs to be established. Over half of our cases were initially assessed by pediatricians and emergency personnel, highlighting the importance of spreading awareness about cutaneous emergencies and providing them with access to a dermatologist's services.
