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Monkeypox is a viral zoonotic disease. It has evolved into human-to-human transmission with similar characteristics to smallpox. In contrast with the previous endemic outbreak, this 2022 multinational outbreak found numerous data of different skin lesions, predilections and populations. Furthermore, recent findings regarding monkeypox revealed the possibility of sexual transmission. As a basis for future monkeypox diagnosis guidelines, providing comprehensive data on the symptoms, predilections, age at presentation, previous history of sexual activities, comorbidities, range of incubation period from the time of sexual activity until the symptoms occured, as criteria for diagnosis of sexual transmitted disease. We performed a comprehensive search on a topic that assesses the outbreak of monkeypox disease in 2022 regarding the route of transmission from inception up until September 2022. There were 1310 patients from 10 studies who had monkeypox disease in 2022. Patients were mostly found in European countries, with averaging in their 30s, and were 99.54% male. Vesiculopustular lesions and ulcers with central umbilication appeared prior to prodromal signs were characteristic. Approximately 90% were transmitted during sexual intercourse and in homosexual group (MSM/Men who have sex with men), and 5-10% between bisexuals. Approximately 40.84% cases also had HIV as a comorbid disease and 15.42% have concurrent or history of sexually transmitted infection (STI) including syphilis, gonorrhea, chlamydia, herpes simplex, mixed, and other STIs. Homosexual and bisexual populations are the most high risk populations in the 2022 outbreak of monkeypox disease. The epidemiology, clinical manifestation, and type of skin lesion were different from the previous outbreak. The findings in this review may supplement information to further establish clinical guidelines on the new presentation of monkeypox disease. Further largescale studies are necessary to further describe and verify the data with higher levels of evidence. [ABSTRACT FROM AUTHOR]

Background Great scientific interest has grown around the role of vitamin D in many chronic diseases, due to its reported immunomodulatory effects and its association with several autoimmune and allergic diseases, including chronic urticaria (CU). Previous studies have shown low serum 25-hydroxyvitamin D [25(OH)D] or calcidiol levels in CU patients, with clinical improvements after vitamin D supplementation. However, data on the correlation between levels of vitamin D in the serum and CU disease activity are still limited, especially in low-middle income tropical countries like Indonesia. Objective We proposed to investigate the correlation between serum calcidiol levels and clinical disease activity in patients with CU. Methods We performed an analytic-descriptive cross-sectional study. Disease activity in CU patients, measured using the Urticaria Activity Score 7 (UAS 7) questionnaire, and serum calcidiol levels were assessed in 30 patients aged 18-59 years with CU. Results Mean UAS7 score was 14.6, median duration of illness was 12 months, and the median serum calcidiol level was 12.1 ng/mL. Most subjects (80%) were vitamin D deficient. We found no statistically significant correlations between serum calcidiol and CU disease activity (r=0.151; p=0.425). However, in subjects with severe vitamin D deficiency, a significant negative correlation was found (r=-0.916; p=0.001). Significant moderate correlation was also found between CU disease activity and illness duration (r=0.391; p=0.033). Conclusion We found no correlations between serum calcidiol levels and CU activity, however there was a tendency of increased CU disease activity in vitamin D deficient patients. [ABSTRACT FROM AUTHOR]