How do they check for the presence of a subcutaneous tick? - briefly
Clinicians palpate the skin for a firm, raised nodule and may employ magnification or ultrasound to visualize a hidden tick. If identified, the area is cleaned and the parasite is extracted with fine forceps.
How do they check for the presence of a subcutaneous tick? - in detail
Detecting a tick lodged beneath the skin requires a combination of visual, tactile, and imaging techniques.
First, a thorough skin examination is performed. The practitioner inspects the entire body surface, paying special attention to areas where ticks commonly attach—scalp, behind ears, neck, armpits, groin, and between toes. A magnifying lens or dermatoscope enhances visibility, allowing identification of the tick’s head or legs protruding from the skin.
Second, palpation helps locate hidden specimens. The examiner gently runs fingertips over the skin, feeling for a firm, raised nodule or a small, mobile lump. A subcutaneous tick often feels like a pea-sized bump with a central point where the mouthparts penetrate.
Third, high‑frequency ultrasound is employed when visual inspection and palpation are inconclusive. A linear transducer (10–15 MHz) reveals a hypoechoic oval structure within the dermis or subcutis, sometimes showing the tick’s body outline and movement. Ultrasound can differentiate a tick from other lesions such as cysts or granulomas.
Fourth, if ultrasound results are ambiguous, magnetic resonance imaging (MRI) may be used. T2‑weighted images display a small, well‑defined lesion with signal characteristics distinct from surrounding tissue, confirming the presence of an arthropod.
Fifth, laboratory confirmation follows removal. The extracted tick is examined under a stereomicroscope to verify species, developmental stage, and engorgement level. Molecular assays (PCR) can detect pathogens carried by the tick, guiding subsequent treatment.
Typical workflow:
- Visual inspection with magnification → identify protruding parts.
- Palpation → detect subdermal nodule.
- High‑frequency ultrasound → visualize embedded body.
- MRI (optional) → resolve doubtful cases.
- Extraction → microscopic and molecular analysis.
These steps provide a systematic, evidence‑based approach to confirming a concealed tick and ensuring appropriate medical response.