Mpox (Formerly Known as Monkeypox) in Dermatological Practice: Presentation of a Series of Four Clinical Cases at a Referral Hospital.

Mpox (formerly known as monkeypox) has re-emerged globally as a significant public health concern, with dermatology services occupying a key role in early recognition due to its predominant mucocutaneous manifestations. We present a series of four confirmed mpox cases diagnosed in April 2025 at a tertiary dermatology center in Jalisco, Mexico. All cases occurred in men who have sex with men, three of whom were living with HIV. Clinical presentations were heterogeneous, ranging from disseminated vesiculopustular eruptions with systemic symptoms to strictly localized, painful perianal lesions without prodrome. One case was initially misdiagnosed as herpes, underscoring the diagnostic complexity and potential overlap with other sexually transmitted dermatoses. Epidemiologic risk factors included recent unprotected sexual encounters and, in one case, recent travel. Diagnosis was confirmed by PCR and supported by compatible histopathology when performed. This cluster within a short timeframe reflects ongoing community transmission and highlights the importance of maintaining high clinical suspicion, integrating empathetic and stigma-free sexual history-taking, and leveraging epidemiologic clues for early detection. Increasing diagnostic awareness in dermatology practice is essential to mitigate under-recognition, guide timely management, and support containment strategies.