Mpox Pain Management with Topical Agents: A Case Series.

With the recent spread in monkeypox cases, continuous efforts are made to manage the disease efficiently. Pain at the site of monkeypox lesions and in areas of skin breakdown can be severe. The origin of pain is likely neuropathic. The Centers for Disease Control and Prevention (CDC) has issued general guidelines to control pain with non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, gabapentin, and topical agents such as corticosteroids and lidocaine. Guidelines circulated by the World Health Organization (WHO) suggest acetaminophen, tramadol, opioids, and/or topical lidocaine for symptomatic pain management. No first line agent with proven beneficial effect has been recommended in these patients. We present two patients' painful experiences with Monkeypox and suggest lessons learned.

Primary Peritoneal Carcinoma: A Rare Malignancy Presenting a Diagnostic Challenge.

With the advancement in technologies and the development of a vast variety of tests, diagnosing diseases has become relatively easy. However, certain diseases are challenging to diagnose due to their similarities with other disease processes. Primary peritoneal carcinoma (PPC) is one of the infrequent tumors that has a resemblance to an ovarian tumor, often making it hard to diagnose. The symptoms are non-specific, and by the time primary peritoneal cancer is diagnosed, the patient is usually at an advanced stage. Although diagnosis might be suspected based on presenting symptoms, it is rarely confirmed with symptomatology alone, requiring additional tumor markers or radiological studies. Sometimes it is diagnosed after surgical removal of the lesion. Several similarities have been described between PPC and ovarian cancer, with some studies explaining the differences as well. We highlight the importance of careful interpretation of imaging studies for the timely diagnosis of PPC. However, several factors can interfere with the analysis of test results leading to delays in diagnosis and management. Interpretation of imaging becomes difficult, especially in patients with significant ascites.