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An. Bras. Dermatol. vol.85 no.3 Rio de Janeiro June 2010
IMAGES IN DERMATOLOGY
Ixodiasis disclosed by epiluminescence microscopy without skin contact*
Paulo Ricardo CriadoI; Roberta Fachini Jardim CriadoII
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
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 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 year2,3 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
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. [ Links ]
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. [ Links ]
3. Vasconcelos W. Dermatozoíases em um imenso país tropical. An Bras Dermatol. 1979;54:87-103. [ Links ]
Mailing Address: Received on 22.02.2010. * The present
study was carried out at "Alergoskin Alergia e Dermatologia" - São paulo
Paulo Ricardo Criado
Hospital das Clínicas da Faculdade de Medicina da USP
Cons.: Alergoskin Alergia e Dermatologia SS Ltda.
Rua Carneiro Leão, 33 - Vila Scarpelli
09150 430 Santo André - SP
Tel.: 11 4426 8803
Approved by the Advisory Board and accepted for publication on 22.02.2010.
Conflict of interest: None
Financial funding: None
Received on 22.02.2010.
* The present study was carried out at "Alergoskin Alergia e Dermatologia" - São paulo (SP), Brazil.