Monkeypox: Skin Lesion Spread From Initial Contact in Three Cases

Monkeypox is a zoonosis caused by the monkeypox virus. In 2022, the World Health Organization declared monkeypox a Public Health Emergency of International Concern due to its unprecedented global spread. Since June 2023, several new cases have re-emerged in mainland China, underscoring the ongoing transmission risk. Our three cases, confirmed by real-time quantitative polymerase chain reaction with dermoscopic and histopathological findings supporting diagnosis, exhibited atypical symptoms consistent with skin contact-mediated transmission. We propose that, in some patients, lesions may initially develop at the site of contact without preceding systemic symptoms and later disseminate to other body regions.