"The clinical presentation is often atypical, with few lesions localized to the genital, perineal/perianal or peri-oral area that do not spread further, and an asynchronous rash that appears prior to the development of a prodromal phase (i.e. lymphadenopathy, fever, malaise)." [1]
[1] https://www.who.int/news/item/25-06-2022-meeting-of-the-inte...