How does a subcutaneous tick appear? - briefly
A subcutaneous tick presents as a firm, raised nodule beneath the skin, often resembling a cyst or mole, sometimes with a tiny central punctum where the parasite’s mouthparts are lodged. The lesion may become inflamed, itch, or develop a visible brownish spot as the tick ages.
How does a subcutaneous tick appear? - in detail
A subcutaneous tick is a parasite that penetrates the dermis and remains entirely beneath the epidermal surface. The process begins when an engorged nymph or adult attaches to the host’s skin, inserts its hypostome, and, instead of remaining partially exposed, advances deeper into the dermal layer. The tick’s mouthparts, equipped with backward‑pointing barbs, anchor securely, preventing easy removal.
The migration proceeds as follows:
- Initial attachment to the epidermis during a blood‑feeding episode.
- Deep insertion of the hypostome through the stratum corneum into the dermis.
- Secretion of cement‑like proteins that harden around the mouthparts, creating a stable subdermal niche.
- Continued expansion of the body as the tick fills with blood, causing a palpable nodule beneath the skin.
Clinical presentation includes a firm, often painless lump that may gradually increase in size. Skin over the nodule may appear slightly erythematous or bruised, but the tick itself is not visible. Symptoms such as localized itching, mild inflammation, or systemic signs (fever, malaise) can develop if infection occurs.
Diagnosis relies on a thorough physical examination, sometimes supplemented by ultrasonography to visualize the tick’s silhouette within the soft tissue. Fine‑needle aspiration or excisional biopsy provides definitive identification.
Removal requires sterile surgical techniques. The recommended steps are:
- Anesthetize the area with a local agent.
- Make a small incision directly over the nodule.
- Extract the tick whole, avoiding rupture of its body to prevent pathogen release.
- Close the incision with a single suture or adhesive strip.
- Administer prophylactic antibiotics if secondary bacterial infection is suspected.
After extraction, the specimen should be sent to a laboratory for species identification and pathogen testing, guiding any necessary antimicrobial therapy. Monitoring the site for signs of infection or residual inflammation continues for several days post‑procedure.