Mpox (Monkeypox)

Skin Lesion: Well-circumscribed, deep-seated, and often umbilicated (dimpled center) papules and vesicles. Lesions progress through stages: macules → papules → vesicles → pustules → crusts.

Classic Progression:

• Prodrome: High fever, intense headache, myalgia, and significant lymphadenopathy (the hallmark sign).
• Synchronous Rash: Unlike Varicella, Mpox lesions in a specific area usually appear in the same stage of development.
• Distribution: Often starts on the face/oral mucosa and spreads to the palms, soles, and genitalia.

Varicella (Chickenpox)

• The Clue: Pleomorphic rash (lesions in different stages present simultaneously) and lacks significant lymphadenopathy.
• Vs Mpox: Mpox lesions are deeper, firmer, and well-circumscribed compared to the superficial "dew drop" vesicles of Varicella. Mpox almost always features lymphadenopathy.

Secondary Syphilis

• The Clue: Generalized maculopapular rash including palms and soles, but usually lacks vesicles or pustules.
• Vs Mpox: Syphilis rash is not typically vesicular or painful. Mpox lesions are distinctly pustular and often painful during the early stages.

🚨 Mandatory Action:

• Notification: Mpox is a notifiable disease.
• Isolation: Strict isolation until all crusts have fallen off and a fresh layer of skin has formed.
• PPE: Use Gown, Gloves, N95 mask, and Eye protection during examination.

Supportive Therapy:

• Hydration: Maintain fluid intake.
• Skin Care: Keep lesions clean and dry. Avoid scratching to prevent secondary bacterial infection.

Symptomatic Treatment

⚠️ Clinical Pearl: Lymphadenopathy (submental, cervical, axillary, or inguinal) is the key clinical feature that distinguishes Mpox from Smallpox and Varicella.

📸 Images