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© The Author(s) 2022, Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware.

Publisher Copyright: © The Author(s) 2022. Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware. publishersversion published

© 2022 European Academy of Dermatology and Venereology., An outbreak of monkeypox has emerged, with more than 2000 cases confirmed across the globe. While this condition, caused by the Monkeypox virus, a member of the Orthopoxvirus genus, is usually considered a zoonosis, we may be facing a sexually transmissible infection (STI), with yet uncertain consequences. In Portugal, we are seeing many suspected cases a day, most of which have been confirmed. At our department, we have had more than 20 confirmed cases, most of which in individuals with concomitant human immunodeficiency virus infection. The typical presentation we are observing is illustrated by the case of a 43-year-old man, with a 3-day history of painful umbilicated vesicles and ulcers localized to the perianal and genital areas (Fig. 1), with no prodromal symptoms. Centimetric elastic inguinal adenopathies were found, but no extrapelvic skin lesions or adenomegalies were present. He had engaged in unprotected receptive and insertive anal intercourse over the past 2 weeks, but the history was otherwise unremarkable. We collected samples from the vesicles, which identified Monkeypox virus in polymerase chain reaction.