Pablo Fernández
Dermatologist at the Hospital Ramón y Cajal and Master in Tropical Medicine at the Universidad Autónoma de Madrid, member and one of the spokespersons of the Spanish Academy of Dermatology and Venereology (AEDV) for monkeypox
It is a very relevant study, published in a high-impact journal. From the dermatological point of view, it gives us a lot of information not only for dermatologists, but also for other specialists, or in the emergency department, to diagnose the disease. This is important in an outbreak such as the current one, which is new and hitherto unknown in our environment.
It is noteworthy that all the cases presented in the paper had skin lesions, the characteristic and constant pustules, which this paper helps to recognise. There are always several lesions and often on more than one area of the body, for example, on the trunk and genitals.
A relevant fact is that all patients evolve well, the symptoms may be uncomfortable (such as itching or pain), but they are not serious.
This is attributable to the fact that the outbreak is due to the Western clade of monkeypox virus and also that the general condition of the patients is good; this differs from the data so far published in African cases, where more severity is observed. This may be due to the fact that in African outbreaks patients often have other concomitant diseases such as malaria, parasitosis or malnutrition.
It should be noted that a significant proportion of patients in this study had sexually transmitted diseases concomitant with the diagnosis of monkeypox. This tells us that in cases of monkeypox it is not only important to consider them in the differential diagnosis, but it is also important to look for these diseases.
The study has been conducted with patients very early in the current outbreak, who took approximately seven days to come to the clinics. We encourage patients to consult early in order to be treated as soon as possible and to help stop the spread of infection.