Subcutaneous tick in a human, how does it appear? - briefly
A subcutaneous tick embeds its mouthparts into the skin, creating a small, firm nodule that may be slightly red or painless. Over days it can enlarge as the tick feeds, sometimes forming a visible bump or ulcerated area where it can be removed.
Subcutaneous tick in a human, how does it appear? - in detail
A tick can become lodged in the dermal and subdermal layers after attaching to the skin. The insect inserts its mouthparts, secretes cement-like proteins, and often remains partially embedded while feeding. The visible part may be a small, raised nodule, sometimes mistaken for a cyst or insect bite. Over several days the nodule enlarges as the tick expands with blood meals, producing a firm, dome‑shaped lump that may be tender or painless.
Typical clinical features include:
- Small, circular elevation (5–10 mm) with a central punctum or black dot representing the tick’s mouthparts.
- Surrounding erythema that may be faint or absent.
- Localized itching, mild pain, or a sensation of movement under the skin.
- Possible regional lymphadenopathy if infection develops.
The progression follows three stages:
- Initial attachment – tick inserts hypostome, anchors with cement; skin reaction is minimal.
- Feeding phase – tick engorges, swelling increases; host may notice a growing bump.
- Detachment or removal – tick drops off or is extracted; residual cavity may persist for days, occasionally forming a granuloma.
Diagnostic steps:
- Visual inspection with magnification to identify the tick’s ventral plates or legs.
- Dermatoscopy to reveal the characteristic “arrowhead” shape of the mouthparts.
- Ultrasonography for deeper lesions, showing a hypoechoic structure with a central echogenic focus.
- Laboratory testing (serology or PCR) if systemic infection (e.g., Lyme disease, rickettsiosis) is suspected.
Management involves careful extraction with fine‑point tweezers, grasping the tick as close to the skin as possible and pulling straight upward to avoid crushing the body. After removal, clean the site with antiseptic, monitor for signs of infection, and consider prophylactic antibiotics if the tick species is known to transmit pathogens and the attachment time exceeds 36 hours.
Complications may include:
- Local inflammation or secondary bacterial infection.
- Transmission of tick‑borne diseases such as Borrelia burgdorferi, Anaplasma, or Babesia.
- Persistent granulomatous reaction requiring surgical excision.
Early recognition of the embedded tick and prompt, complete removal reduce the risk of systemic illness and minimize tissue damage.