Comparison of human monkeypox, chickenpox and smallpox: a comprehensive review of pathology and dermatological manifestations.

Variola virus, the causing agent of smallpox, was eradicated in 1980s and today no new cases are reported. The first human infectious illness to be eliminated globally is variola. On the contrary to Variola, monkeypox, which is a zoonotic and variola-like disease, has nowadays turned to be a major health problem worldwide. VZV is a neurotropic virus and the cause of varicella (chickenpox) and herpes zoster (shingles), which is also a highly infectious disease, especially prevalent in children. These three skin diseases-monkeypox, smallpox, and chickenpox-are frequently mistaken with one another due to similar manifestations including fever, rash, myalgia, chills and headache, but they can all be distinguished by their distinctive symptoms. Although these rash-causing disorders might present different skin lesions; diagnostic tests can be extremely useful in their differentiation. We searched for these concepts on a search engine like Google Scholar, scanning the results for alternative words and phrases, and examined relevant abstracts or articles for alternative words. The clinical diagnosis of monkeypox infection is commonly made based on the occurrence pattern of its skin rash. It is possible in varicella to concurrently identify lesions in their various stages including macular, papular, vesicular, pustular, and crusts; however, monkeypox lesions are all in the same stage and evolve with the same rate. In this review, we have tried to provide a holistic and comprehensive comparison between these three skin infections with a focus on the newly epidemic monkeypox, bringing about the most recent knowledge about its features and its diagnosis.

[Varicella-associated purpura fulminans and deep vein thrombosis: a pediatric case report]. / Purpura fulminans post-varicelleux et thrombose veineuse : à propos d'un cas pédiatrique.

Purpura fulminans (PF) and deep vein thrombosis are rare complications secondary to chicken pox disease. The presence of antibodies reflects an ongoing immunological process and requires specialized management. The present study reports a 4-year-old boy with no medical history who presented with purpura on the legs 10 days after chicken pox eruption. Laboratory tests showed a disseminated intravascular coagulation associated with low plasma protein C and S activities, and the presence of anti-protein S antibodies. A replacement therapy with protein C infusions and fresh frozen plasma was prescribed. The patient also underwent regular sessions of hyperbaric oxygen followed by the surgery. Fourteen days after the beginning of the purpuric lesions, he presented deep vein thrombosis (DVT) of the lower limbs and was treated with unfractionated heparin. This case report illustrates the pathophysiology of DVT occurring in a patient with chicken pox disease (i.e., acquired protein C and S deficiencies and anti-protein S autoantibodies) and emphasizes the utility of thrombophilia testing in order to better adapt treatment.

Estudio exploratorio prospectivo de cohortes sobre el tratamiento de la varicela, con homeopatía y tratamiento sintomático / Exploratory prospective cohort study about the treatment of chicken pox, with homeopathy and with symptomatic treatment

Introducción: Existen grandes dificultades para realizar ensayos clínicos con homeopatía, por lo que persiste la controversia sobre su eficacia. No se ha analizado nunca el impacto de la homeopatía sobre la evolución de la varicela. Pacientes y métodos: Estudio exploratorio prospectivo de cohortes. Se efectuó un seguimiento de 160 niños menores de 15 años en tres grupos de tratamiento: homeopatía (grupo1), tratamiento sintomático (grupo 3) o tratamiento mixto (grupo 2). El seguimiento de los sujetos se efectuó hasta el final de la clínica, se contabilizó el número de lesiones en el tronco y se analizó la evolución de los síntomas, como fiebre, picor, malestar, alteración del sueño, apetito y cefalea. Resultados: El grupo tratado con homeopatía tenía una edad mayor (de 5,6 años, frente a 4,2 años en el grupo 3). No hubo diferencias en la presencia de fiebre, picor y número de lesiones en la visita en el momento del diagnóstico. En el grupo tratado con homeopatía, respecto al que recibió tratamiento sintomático, se observó una menor duración de la fiebre (1,4 frente a 2,4 días), de las lesiones de rascado (1,4 frente a 1,8 días) y de las lesiones (6,6 frente a 9,2 días), sin modificarse el resto de las variables. Conclusiones: En este estudio exploratorio y observacional, el tratamiento homeopático indica un beneficio potencial en la reducción de la sintomatología y en la duración de la varicela (AU)

Introduction: It is difficult to carry out clinical trials with homeopathy, and therefore the controversy about its efficiency continues. There is no description, so far, about the impact of homeopathy on chicken pox. Patients and methods: Exploratory prospective cohort study. Follow up on 160 children less than 15 years of age in three groups treated with homeopathy (group 1), conventional treatment (group3) or both (group 2). The subjects where followed up until the end of convalescence. These were Number of skin lesions on the thorax, and evolution of symptoms as fever, itching, discomfort, sleep disorder, hunger and headache was analyzed. Results: The group treated with homeopathy had an age older than (5.6 years vs. 4.2 yrs in group 3), with no differences in the presence of children with fever, itching and number of lesions at the first visit. In the group treated with homeopathy, respect to the one that received symptomatic treatment there was a significant lower duration of fever (1.4 vs. 2.4 days), less length of the scratching lesions (1.4 vs. 1.8 days) and in the duration of the lesions (of 6.6 in the group treated with homeopathy and 9.2 days in the symptomatic group), without any modification in the rest of the variables. Conclusions: In this exploratory observational study the homeopathic treatment indicates a possible benefit in reducing the symptoms and the duration of the chicken pox (AU)

Acyclovir-resistant varicella infection with atypical lesions in a non-HIV leukemic infant.

UNLABELLED: An HIV-negative infant presented with VZV primary infection during the maintenance therapy for megakaryoblastic leukaemia. The lesions were initially vesicular and necrotic but became verrucous and hyperkeratotic. A clinical resistance to acyclovir was suspected and confirmed by histologic and virologic studies. The patient was successfully treated by foscarnet. CONCLUSION: resistance of VZV to acyclovir may occur after a short treatment in a non-AIDS patient.