Ixodiasis disclosed by epiluminescence microscopy without skin contact

Abstracts

Nós descrevemos um homem de 48 anos que procurou nossa clínica com múltiplas pápulas eritematosas e pruriginosas dois dias após uma viagem à Serra da Mantiqueira. O exame físico meticuloso com o dermatoscópio de epiluminescência demonstrou múltiplos carrapatos na fase de larva na pele.

Carrapatos; Dermoscopia; Infestações por carrapato; Ixodes

IMAGES IN DERMATOLOGY

Ixodiasis disclosed by epiluminescence microscopy without skin contact^*

Paulo Ricardo Criado^I; Roberta Fachini Jardim Criado^II

^IDoctorate degree (Dermatology), Faculty of Medicine, University of São Paulo (FMUSP), Doctor in the Division of Dermatology at the University Hospital of the Faculty of Medicine of the University of São Paulo (FMUSP) - São Paulo (SP), Brazil

^IIMaster degree of Medicine from the Institute of Medical Care to the Civil Servants of the state of São Paulo (Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo) - Allergist, professor of Dermatology at the Faculty of Medicine of the ABC region, São Paulo (SP) - Brazil

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ABSTRACT

We describe the case of a 48-year-old healthy man who sought for medical help in our clinic with multiple pruriginous erythematous papules after a 2-day trip to "Serra da Mantiqueira". (Mantiqueira Mountain). A meticulous physical exam with a portable epiluminescence microscopy showed several ticks on a larval form on the skin of the patient.

Keywords: Dermoscopy; Ixodes; Ticks; Tick infestations

White man, aged 48, coming from São Paulo sought our private clinic complaining of intense itching all over his body which had been lasting for two days. The eruption, a pruriginous erythematouspapulous rash had started during a trip to the region known as "Circuito das Águas" (Mantiqueira mountain).

The clinical examination of the erythematouspapulous lesions (Figures 1A and 1B) using a DermLite DL 100 dermatoscope revealed inumerous ticks. (Figures 1C, 1D and 1E).

The tick called A. cajennense, in the south east An Bras Dermatol. 2010;85(3):389-90. region of Brazil, has three parasitic stages distributed throughout the year^2,3 The larvas, known as "micuim", are predominant from April to July; the nymphas, called "vermelhinho", are predominant from July to October and the adults called "rodoleiro" or "carrapato estrela" (star-tick) grow in the warm and rainy period from October to March.

When the nymphas live piled up, its parasitism is intense as from its creeping leaves they pass over to man (you have only to touch them) resulting in erythematous papules with central "inoculum" and intensely pruriginous. ³

REFERENCES

• 1. de Lemos ER, Machado RD, Pires FD, Machado SL, da Costa LM, Coura JR. Rickettsiae-infected ticks in an endemic area in spotted fever in the State of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz. 1997;92:477-81.
• 2. Labruna MB, Kasai N, Ferreira F, Faccini JL, Gennari SM. Seasonal dynamics of ticks (Acari: Ixodidae) on horses in the state of São Paulo, Brazil. Vet Parasitol. 2002;105:65-77.
• 3. Vasconcelos W. Dermatozoíases em um imenso país tropical. An Bras Dermatol. 1979;54:87-103.

*

Trabalho realizado na Alergoskin Alergia e Dermatologia - São Paulo (SP), Brasil.

Publication Dates

• Publication in this collection
  24 Sept 2010
• Date of issue
  June 2010

History

• Received
  22 Feb 2010
• Accepted
  22 Feb 2010