Oral lesions in patients with human monkeypox: A systematic scoping review

To describe the clinical features and location of oral lesions in patients with human monkeypox.

A systematic scoping review was accomplished by implementing the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. The analysis incorporated varied databases and the gray literature. Keywords were implemented to search publications in all languages until July 2022.

The initial electronic exploration included 889 reports, of which 843 studies were eliminated. Reading the full text occasioned the omission of 27 additional investigations. Finally, 19 publications were included. These reports analyzed 1256 patients with monkeypox, mostly described in Europe. Most of them were men who have sex with men. The study population consisted mainly of adults but children were also infected. The oral lesions of monkeypox patients were observed in different parts of the oral mucosa, including lips and tongue, but mainly in the tonsils (15 cases). The oral lesions manifested as papules, vesicles, pustules, and ulcers. Erythema, edema, enanthema, and severe pain were also observed, accompanied by tonsillar enlargement. Sore throat was also reported. Monkeypox is accompanied by a significant number of systemic manifestations, mainly including multiple skin lesions throughout the body, as well as lymphadenopathy, fever, headache, myalgia, and fatigue, among others. The symptoms associated with monkeypox were managed with different antiretroviral and antimicrobial therapies and medications to control pain and fever principally. Seventeen deaths were informed.

Most monkeypox-associated oral lesions are seen in different parts of the oral mucosa, mainly in the tonsils manifested as papules, vesicles, pustules, and ulcers.