Monkeypox: a new (sexually transmissible) epidemic?

© 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.