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Global Health

Mpox—A Rapidly Evolving Disease

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JAMA Dermatology

Published Online: February 9, 2023

Special Communication

Article Information and Disclosures

Edward W. Cowen, MD, MHSc¹;

Eric R. Tkaczyk, MD, PhD^2,3;

Scott A. Norton, MD, MPH, MSc⁴;

Kieron S. Leslie, MBBS, DTM&H⁵

Author Affiliations

¹Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland
²Dermatology Service and Research Service, Department of Veterans Affairs, Nashville, Tennessee
³Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
⁴Department of Dermatology, George Washington University, Washington, DC
⁵Department of Dermatology, University of California, San Francisco

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Abstract

The 2022 mpox outbreak has rapidly emerged onto the global medical scene while the world continues to grapple with the COVID-19 pandemic. Unlike COVID-19, however, most patients with mpox present with skin findings, the evolving clinical presentation of which may be mistaken for other common skin diseases, particularly sexually transmitted infections. This Special Communication provides an overview of the evolution of mpox skin findings from its initial description in humans in 1970 to the present-day multinational outbreak.

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Article Information

Accepted for Publication: January 10, 2023.

Published Online: February 9, 2023. doi:10.1001/jamadermatol.2023.0041

Corresponding Author: Edward W. Cowen, MD, MHSc, Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Dr, Bethesda, MD 20892 (cowene@mail.nih.gov).

Author Contributions: Dr Cowen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Cowen, Tkaczyk, Leslie.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Obtained funding: Tkaczyk.

Administrative, technical, or material support: Tkaczyk, Leslie.

Supervision: Cowen, Tkaczyk.

Conflict of Interest Disclosures: Dr Tkaczyk reported receiving grants from the US Department of Veterans Affairs and National Institutes of Health during the conduct of the study. No other disclosures were reported.

Funding/Support: This research was supported by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases and a Career Development Award from US Department of Veterans Affairs Clinical Sciences R&D Service (IK2 CX001785).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank the patient in eFigure 2 for granting permission to publish this information. We also thank Madeline Marks, BS, for her assistance composing Figure 1; Monica Valentin, MD, and Christen Samaan, MD, for assistance composing the Table; and Jason Zucker, MD, for additional clinical images. The individuals were not compensated for these contributions.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.