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| THROUGH THE DERMOSCOPE |
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| Year : 2020 | Volume
: 11
| Issue : 4 | Page : 682-683 |
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Dermoscopy-Assisted tick extraction
Mahesh Mathur, Prakash Acharya, Alina Karki
Department of Dermatology, College of Medical Sciences, Bharatpur, Nepal
| Date of Submission | 28-Nov-2018 |
| Date of Decision | 29-Dec-2018 |
| Date of Acceptance | 05-Feb-2019 |
| Date of Web Publication | 26-Sep-2019 |
Correspondence Address:
Prakash Acharya
Department of Dermatology, College of Medical Sciences, Bharatpur, Chitwan
Nepal
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/idoj.IDOJ_459_18
How to cite this article:
Mathur M, Acharya P, Karki A. Dermoscopy-Assisted tick extraction. Indian Dermatol Online J 2020;11:682-3 |
A 25-year-old male presented with swelling and pain over the right postauricular area since one day. On examination, a tick was noted at the center of the lesion [Figure 1]. Dermoscopy (Firefly DE300, 20×, polarized mode) revealed pinkish-red area at the center of the lesion and confirmed the tick as nymphal form of Amblyomma [Figure 2]a. The tick was pulled upward using a sterilized tweezer applying a steady pressure under the guidance of dermoscope. Reevaluation of the lesion using dermoscope revealed a pale area with scaling at the point of attachment and no remnants from the tick [Figure 2]b. Dermoscopy of the retrieved tick revealed intact hypostome [Figure 2]b. The lesion subsided after 7 days of oral flucloxacillin with no further complaints during the 1month observation period.{Figure 1}{Figure 2}
Early diagnosis may reduce the morbidity and mortality of different tick-borne diseases.[1] Oiso et al.[1] and Matsuda et al.[2] in two different case reports emphasized the use of dermoscope for the diagnosis of a tick bite. Incomplete removal of the tick with the persistent presence of the hypostome in the skin can lead to infection or granuloma.[1] Zalaudek et al.[3] pointed out the use of dermoscope to confirm the complete removal of the tick. In view of the recent report of tick-borne disease like Lyme disease in Nepal in 2018 and multiple reports of the same disease in India recently,[4],[5] we would like to emphasize the use of dermoscope for the diagnosis, identificationof the type, and complete removal of the tick.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Oiso N, Kawara S, Yano Y, Kawada A. Diagnostic effectiveness of dermoscopy for tick bite. J Eur Acad Dermatol Venereol 2010;24:231-2.  |
| 2. | Matsuda M, Oiso N, Yano Y, Kawada A. Dermoscopy for tick bite: Reconfirmation of the usefulness for the initial diagnosis. Case Rep Dermatol 2011;3:94-7. |
| 3. | Zalaudek I, Giacomel J, Cabo H, Di Stefani A, Ferrara G, Hofmann-Wellenhof R, et al. Entodermoscopy: A new tool for diagnosing skin infections and infestations. Dermatology 2008;216:14-23. |
| 4. | Pun SB, Agrawal S, Jha S, Bhandari LN, Chalise BS, Mishra A, et al. First report of Lyme disease in Nepal. JMM Case Rep 2018;5:e005128. |
| 5. | Jairath V, Sehrawat M, Jindal N, Jain VK, Aggarwal P. Lyme disease in Haryana, India. Indian J Dermatol Venereol Leprol 2014;80:320-3. [ PUBMED] [Full text] |
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