Indexed with PubMed and Science Citation Index (E) 
Users online: 4107 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Article in PDF (650 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

  In this article
   Article Figures

 Article Access Statistics
    PDF Downloaded101    
    Comments [Add]    

Recommend this journal


 Table of Contents    
Year : 2014  |  Volume : 80  |  Issue : 3  |  Page : 269-270

Tick bite

1 Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
2 Department of Dermatology, University of Osnabrueck, Osnabrueck, Lower Saxony, Germany

Date of Web Publication12-May-2014

Correspondence Address:
Min Zheng
Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou - 310009, Zhejiang Province, China

Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0378-6323.132265

Rights and Permissions

How to cite this article:
Liu CC, Landeck L, Zheng M. Tick bite. Indian J Dermatol Venereol Leprol 2014;80:269-70

How to cite this URL:
Liu CC, Landeck L, Zheng M. Tick bite. Indian J Dermatol Venereol Leprol [serial online] 2014 [cited 2020 Aug 11];80:269-70. Available from:


A 23-year-old girl presented to our department with a 1 month history of an embedded tick on her right clavicle. The patient had no fever, chills or other systemic symptoms. Physical examination revealed a live tick that was stuck very firmly to the skin of the right clavicle area and was seen to swing its feet [Figure 1]a. Erythema was noticed around the attachment site [Figure 1]a. Initial laboratory investigations were unremarkable. To avoid leaving the mouthparts of the tick embedded in the skin, a limited skin surgical excision including epidermis and dermis of diameter and depth of 4 mm to 6 mm of the entire area around the bite was performed to remove it completely. Histopathological examination showed a tick body full of blood with the mouthpart embedded in the upper dermis, with necrotized skin tissue around it [Figure 1]b. Vessel dilatation and neutrophil infiltrate in the dermis were also observed [Figure 1]b.
Figure 1: (a) A live tick stuck to the skin of right clavicle area (b) Histological examination of the tick in the skin (H and E, ×4)

Click here to view

Ticks are blood feeding external parasites which can cause local and systemic complications, including Lyme disease, tick-borne-encephalitis, tick-borne lymphadenopathy, secondary bacterial skin infection, reactive manifestations against tick allergens and granuloma formation. [1] During 3 months of follow-up, our patient did not show any systemic symptoms indicating that she just suffered a tick bite but did not acquire any tick-transmitted diseases.

Any tick found should be immediately and completely removed alive. Many methods of tick removal have been reported in the literature. Topical application of 2% erythromycin and 3% tetracycline preparations are ineffective in eliminating Borrelia burgdorferi from the tick bite site or in preventing dissemination to other tissues. [2] Limited surgical excision is an appropriate and safe tick removal technique and could remove the tick completely [3] without provoking the escape of infective body fluids from the tick into the wound site.

Persons who have undergone tick removal should be monitored for up to 30 days for signs and symptoms of tick-borne diseases. Tick numbers and tick-borne diseases should be regularly monitored in areas with a high risk of tick attacks.

  References Top

1.Roupakias S, Mitsakou P, Nimer AA. Tick removal. J Prev Med Hyg 2011;52:40-4.  Back to cited text no. 1
2.Wormser GP, Daniels TJ, Bittker S, Cooper D, Wang G, Pavia CS. Failure of topical antibiotics to prevent disseminated Borrelia burgdorferi infection following a tick bite in C3H/HeJ mice. J Infect Dis 2012;205:991-4.  Back to cited text no. 2
3.Roupakias S, Mitsakou P, Nimer AA. Surgical tick removal. Wilderness Environ Med 2012;23:97-9.  Back to cited text no. 3


  [Figure 1]


Print this article  Email this article


Online since 15th March '04
Published by Wolters Kluwer - Medknow