Fisher Emily J, Mo Jun, Lucky Anne W
Division of Pediatric Dermatology and Department of Pathology, Cincinnati Children's Hospital Medical Center, OH 45267, USA.
Arch Dermatol. 2006 Apr;142(4):491-4. doi: 10.1001/archderm.142.4.491.
Ticks are the second most common vectors of human infectious diseases in the world. In addition to their role as vectors, ticks and their larvae can also produce primary skin manifestations. Infestation by the larvae of ticks is not commonly recognized, with only 3 cases reported in the literature. The presence of multiple lesions and partially burrowed 6-legged tick larvae can present a diagnostic challenge for clinicians.
We describe a 51-year-old healthy woman who presented to our clinic with multiple erythematous papules and partially burrowed organisms 5 days after exposure to a wooded area in southern Kentucky. She was treated with permethrin cream and the lesions resolved over the following 3 weeks without sequelae. The organism was later identified as the larva of Amblyomma species, the lone star tick.
Multiple pruritic papules can pose a diagnostic challenge. The patient described herein had an unusually large number of pruritic papules as well as tick larvae present on her skin. Recognition of lone star tick larvae as a cause of multiple bites may be helpful in similar cases.
蜱是世界上人类传染病的第二大常见传播媒介。除了作为传播媒介的作用外，蜱及其幼虫还可引起原发性皮肤表现。蜱幼虫感染并不常见，文献中仅报道过3例。多个皮损以及部分钻入皮肤的6条腿的蜱幼虫的存在可能给临床医生带来诊断挑战。
我们描述了一名51岁的健康女性，在接触肯塔基州南部的林区5天后，出现多个红斑丘疹和部分钻入皮肤的生物体，前来我们诊所就诊。她接受了氯菊酯乳膏治疗，皮损在接下来的3周内消退，无后遗症。该生物体后来被鉴定为美洲钝眼蜱属（Amblyomma）的幼虫，即孤星蜱。
多个瘙痒性丘疹可能带来诊断挑战。本文所述患者皮肤上有异常大量的瘙痒性丘疹以及蜱幼虫。认识到孤星蜱幼虫是多次叮咬的原因，在类似病例中可能会有所帮助。
