Mpox: an updated review of dermatological manifestations in the current outbreak.

Monkeypox (mpox) is a disease caused by a double-stranded DNA orthopoxvirus discovered in 1958. In 2022 an outbreak on an unprecedented scale marked its transition from neglected, zoonotic disease circulating almost exclusively within African borders to sexually transmitted infection (STI) of international concern. Although phylogenetic evidence suggests progressive evolution from the strain associated with the 2018 outbreak in Nigeria, epidemiological links with previous cases are still incompletely elucidated. Clinically, mpox presents with systemic symptoms, such as fever, headache, malaise, and a characteristic cutaneous eruption, similar to that of cognate viruses (e.g., smallpox). Mpox pseudo-pustules evolve through several stages, including umbilication and crusting, and resolve in the span of 2-3 weeks. Disproportionate affection of men that have sex with men, an often localized cutaneous picture and a significant burden in terms of concomitant STIs were the hallmarks setting the 2022 outbreak apart from classic mpox. Investigations into the disease pathogenesis, related immune response, clinical and dermoscopic features, as well as studies aimed at defining novel management strategies, have advanced mpox knowledge considerably. Herein, recent findings on mpox are reviewed, with a keen focus on dermatological manifestations and their implications in the current diagnostic scenario, reinforcing the pivotal role of dermatologists in managing suspect cases and preventing further spread of the contagion.