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Year : 2020  |  Volume : 11  |  Issue : 4  |  Page : 682-683  

Dermoscopy-Assisted tick extraction

Department of Dermatology, College of Medical Sciences, Bharatpur, Nepal

Date of Submission28-Nov-2018
Date of Decision29-Dec-2018
Date of Acceptance05-Feb-2019
Date of Web Publication26-Sep-2019

Correspondence Address:
Prakash Acharya
Department of Dermatology, College of Medical Sciences, Bharatpur, Chitwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/idoj.IDOJ_459_18

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How to cite this article:
Mathur M, Acharya P, Karki A. Dermoscopy-Assisted tick extraction. Indian Dermatol Online J 2020;11:682-3

How to cite this URL:
Mathur M, Acharya P, Karki A. Dermoscopy-Assisted tick extraction. Indian Dermatol Online J [serial online] 2020 [cited 2021 Jan 27];11:682-3. Available from: https://www.idoj.in/text.asp?2020/11/4/682/261229

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.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Oiso N, Kawara S, Yano Y, Kawada A. Diagnostic effectiveness of dermoscopy for tick bite. J Eur Acad Dermatol Venereol 2010;24:231-2.  Back to cited text no. 1
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.  Back to cited text no. 2
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.  Back to cited text no. 3
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.  Back to cited text no. 4
Jairath V, Sehrawat M, Jindal N, Jain VK, Aggarwal P. Lyme disease in Haryana, India. Indian J Dermatol Venereol Leprol 2014;80:320-3.  Back to cited text no. 5
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