The outbreak of monkeypox in the European region is characteristic of males between 31 and 40 years old, predominantly among men who have sex with men. Although cases outside endemic regions are often linked to international travel, in this outbreak there are no travel links to Africa. Human-to-human transmission occurs by direct contact including during sex, as we described in our case. The clinical presentations in this outbreak are unusual with lesions in the ano-genital region and mild prodromal symptoms. Hence, the disease could be confused with sexually transmitted infections (secondary syphilis, genital herpes, chancroid) or varicella-zoster virus infection. This stresses the importance that dermatologists at outpatient clinics identify and isolate cases early and promptly trace contacts. Dermatologists should remain vigilant, although monkeypox is not a classic venereal disease, it could be transmitted during sexual intercourse.