Traditionally, patients develop a characteristic rash that generally starts on the face and body and spreads centrifugally to the palms and soles it may be preceded by a rash affecting the oropharynx and tongue in the 24 hours prior.
Lesions simultaneously progress through four stages - macular, papular, vesicular, and pustular - before scabbing over and resolving. Lesions are typically 5 to 10 mm in diameter, may be discrete or confluent, and may be few in number or several thousand.
Vesicles are well-circumscribed and located deep in the dermis. The rash usually resolves over a period of 2 to 4 weeks. Clinical management and infection prevention and control for monkeypox: interim rapid response guidance, 10 June Jun [internet publication].
Mpox monkeypox : fact sheet. Aug [internet publication]. Chapter Human monkeypox and other poxvirus infections of man. In: Smallpox and its eradication. Geneva: World Health Organization; Human monkeypox. Clin Infect Dis. Clinical features of mpox. Sep [internet publication]. In more recent outbreaks, the presentation has been atypical, with the rash presenting primarily in the anogenital region. Human monkeypox: a comparison of the characteristics of the new epidemic to the endemic disease.
BMC Infect Dis. Multi-country monkeypox outbreak: situation update. Demographic and clinical characteristics of confirmed human monkeypox virus cases in individuals attending a sexual health centre in London, UK: an observational analysis. Lancet Infect Dis. Monkeypox cases reported in UK and Portugal.
