A Case Report of Monkeypox in an Adult Patient from Italy: Clinical and Dermoscopic Manifestations, Diagnosis and Management
Ilaria Proietti,
Paolo Emilio Santoro,
Nevena Skroza,
Tiziana Tieghi,
Nicoletta Bernardini,
Ersilia Tolino,
Agnieszka Ewa Dybala,
Antonio Di Guardo,
Alessandra Rallo,
Marco Di Fraia,
Maria Francesca Rossi,
Martina Vitiello,
Umberto Moscato,
Giovanni Pellacani,
Miriam Lichtner,
Concetta Potenza
Affiliations
Ilaria Proietti
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Paolo Emilio Santoro
Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
Nevena Skroza
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Tiziana Tieghi
Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
Nicoletta Bernardini
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Ersilia Tolino
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Agnieszka Ewa Dybala
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Antonio Di Guardo
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Alessandra Rallo
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Marco Di Fraia
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Maria Francesca Rossi
Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
Martina Vitiello
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Umberto Moscato
Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
Giovanni Pellacani
Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
Miriam Lichtner
Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
Concetta Potenza
Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.
