Managing Monkeypox Virus: Characterizing Common Cutaneous Manifestations and Antiviral Efficacy.

Background: The Monkeypox virus (MPX) has been detected in multiple non-endemic countries since May 2022. The cutaneous manifestations of MPX can have multiple distinct presentations, including pustular and vesicular. Although there are no approved treatments, three antivirals (brincidofovir, cidofovir, tecovirimat) have been utilized. The objective of our study was to conduct a systematic review to evaluate antiviral efficacy (first aim) and cutaneous manifestations of MPX (second aim).

Methods: Utilizing PRISMA guidelines, we searched PubMed and SCOPUS databases to identify studies utilizing antiviral treatment in human subjects for MPX and studies reporting cutaneous characteristics of MPX lesions.

Results: For our first aim, six articles met inclusion criteria. For our second aim, 27 met inclusion criteria. Eighty-eight percent had complete resolution with tecovirimat (n=28) which was well tolerated, and decreased hospitalization time (10 days) compared to brincidofovir (29 days). Forty-four percent of patients had <10 cutaneous lesions and 36% had 10-100 lesions. The most common lesion type was pustular (32%, n=380).

Conclusion: This limited sample of studies suggests that tecovirimat is well tolerated and may be an effective antiviral for MPX treatment. Further studies are required to better understand the role of antivirals for MPX treatment among human patients. J Drugs Dermatol. 2023;22(3): doi:10.36849/JDD.7263.