Multiple pruritic papules from lone star tick larvae bites

Archives of Dermatology
Emily J FisherAnne W Lucky

Abstract

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.

Citations

Jan 4, 2008·Vector Borne and Zoonotic Diseases·Ellen Y StromdahlPhillip C Williamson
Jul 21, 2011·Ticks and Tick-borne Diseases·N OisoA Kawada
Apr 23, 2009·Australian Veterinary Journal·Cg BaxterSl Doggett
Jul 28, 2007·The British Journal of Dermatology·P Del GiudiceE Counillon
Mar 19, 2013·Zoonoses and Public Health·E Y Stromdahl, G J Hickling
Jun 13, 2018·Experimental Dermatology·Takashi HashimotoGil Yosipovitch
Jun 8, 2013·Current Opinion in Allergy and Clinical Immunology·Scott P Commins, Thomas A E Platts-Mills
Dec 29, 2020·The Journal of Allergy and Clinical Immunology·Xueke LiZhijian Cao

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