Clinical progression of genital lesions in patients with mpox (monkeypox)

Lesions appeared 1 to 3 days after systemic symptoms, clustered (anal area 1A) or isolated (skin or penis 1B-1C). They typically began as raised, itchy papules secreting serous, with a central umbilication; over days, the central umbilication widened until the lesion opened and the scab formed about 2 weeks after symptom onset.