Kallini Joseph R, Khachemoune Amor
Detroit Medical Center / Wayne State University, Detroit, Michigan.
Veterans Affairs Medical Center, Brooklyn, New York.
J Clin Aesthet Dermatol. 2017 Mar;10(3):46-50. Epub 2017 Mar 1.
To describe a man with an adherent tick mimicking a melanoma, summarize the salient features of this condition, and review other cases of ticks mistaken for dermatoses. Ticks are obligatory ectoparasites. Disease-causing ticks belong to two families: (hard ticks) and (soft ticks). Ticks thrive by consuming blood from animal hosts, and the transfer of infected blood from one host to the next is the method by which ticks spread disease. The authors describe a man who presented to their dermatology clinic in New York with an unusual black pigmented lesion on the right zygomatic region of his face. He was worried about how rapidly the lesion had developed and the tingling of the skin surrounding it. Since the patient had a history of nonmelanoma skin cancer, he was concerned that the lesion was a melanoma. An excisional biopsy of the lesion revealed a non- tick with a surrounding tick-bite reaction. Ticks cause cutaneous manifestations through physical trauma and their salivary contents. A number of reports describe a similar phenomenon of a persistent tick being mistaken for a nodule or tumor. Management includes complete removal of a tick, either mechanically or surgically, along with the appropriate work-up for tick-borne diseases in the relevant geographic location. The decision to test for systemic disease depends on the clinical presentation of the patient and geographic location of the tick bite. A patient presented to the authors' dermatology clinic with a pigmented lesion suspicious for a melanoma, but the lesion was actually an adherent non- tick. This case illustrates the importance of keeping insects and arthropods in the differential diagnosis of a sudden- and recent-onset pigmented skin lesion.
描述一名患有酷似黑色素瘤的附着蜱虫的男子，总结这种情况的显著特征，并回顾其他被误诊为皮肤病的蜱虫病例。蜱虫是专性体外寄生虫。致病蜱虫属于两个科：（硬蜱）和（软蜱）。蜱虫通过吸食动物宿主的血液而繁衍，而感染血液从一个宿主传播到另一个宿主是蜱虫传播疾病的方式。作者描述了一名男子，他前往纽约的皮肤科诊所，面部右侧颧区有一个异常的黑色色素沉着病变。他担心病变发展迅速以及周围皮肤有刺痛感。由于该患者有非黑色素瘤皮肤癌病史，他担心这个病变是黑色素瘤。对该病变进行切除活检发现是一只未脱落的蜱虫，周围有蜱虫叮咬反应。蜱虫通过物理创伤及其唾液成分导致皮肤表现。许多报告描述了类似的现象，即持续存在的蜱虫被误认为是结节或肿瘤。处理方法包括通过机械或手术完全移除蜱虫，以及针对相关地理位置的蜱传疾病进行适当的检查。是否检测全身性疾病取决于患者的临床表现和蜱虫叮咬的地理位置。一名患者前往作者的皮肤科诊所，有一个疑似黑色素瘤的色素沉着病变，但实际上该病变是一只附着的未脱落蜱虫。这个病例说明了在突然出现且近期发生的色素沉着皮肤病变的鉴别诊断中考虑昆虫和节肢动物的重要性。
