Dermoscopic diagnosis of a tick bite

A 72-year-old man presented with complaints of an itchy, mildly tender, reddish raised skin lesion over his right thigh for the past 4 days [Figure 1]. There was no history of trauma, insect bite or local application of any medications. He reported that the onset was following his routine gardening activity. He was a dog lover and used to raise pets. A dermoscopic examination was performed, and an intact tick was noted at the centre of the lesion [Figure 2]. The tick was manually removed using a non-toothed forceps. This case report emphasizes the usefulness of dermoscopic examination in the diagnosis of atypical lesions.

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Figure 1:

A single, ill-defined, slightly indurated and mildly tender erythematous plaque was seen clinically on the medial aspect of right thigh of a 72-year-old male.

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Figure 2:

Intact tick at the centre of the lesion on dermoscopic examination (Dino- lite edge AF4115, polarizing mode, magnification 110X).

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