Ticked Off

Ixodes holocyclus

She came to see me for a mole on her back that her husband thought looked suspicious. When I put my magnifier close to see for myself the ‘mole’ waved at me. Needless to say, I didn’t wave back. Summer is in full swing and many of us enjoy the great outdoors, taking advantage of the beautiful weather. Unfortunately, on occasion we may bring a bit of the outdoors with us, or possibly on us. We discussed before how each of us must stay alert for skin lesions caused by sun damage. Now, we have to watch for lesions (bugs actually) that may have parasitically attached themselves to us. One of these parasites, the tiny tick (as shown in the photo), can cause more harm than one may realize at first. These little buggers can pass on diseases to humans and animals resulting in illnesses exceptionally difficult to treat.

One such disease, called Lyme disease, can cause rash and flu-like symptoms. If left untreated, it can affect almost every organ system in the body. Generalized muscle aches, fever, headache and eventually arthritis-like joint pains may develop if left untreated. Blood tests aren’t that helpful in the very early stages of the disease. If the characteristic rash is present (and in 25% there is no rash), your physician may choose to treat with simple antibiotics to prevent the late complications. Another tick-borne disease, called Rocky Mountain Spotted Fever, may also cause fever, nausea and vomiting and generalized muscle pains. Initial blood tests are sometimes helpful in identifying this malady, allowing your physician to give prompt and proper antibiotics. Other infections brought by our tick friends cause similar maladies.

Prevention, of course, is always the key to cut our likelihood of bringing home one of these hitch hikers. Wearing light-colored clothing makes the tick stand out, but many of us wear shorts when its hot leaving lots of epidermal real estate exposed. Tick repellants may help but require frequent reapplication. Checking our skin carefully is the best way to make sure that any new lesion is not actually a new multi-legged friend. Removal of these pests by yourself or your physician is straight-forward. Forget the salves, nail polish and most of all heated match sticks. Removal with tweezers is the best way to prevent further damage.

That’s what we did for this patient’s ‘mole’. It came straight out with tweezers—still waving, although now a little more frantically. We disposed of it appropriately and treated the patient’s new wound. We discussed dressing appropriately when outdoors and applying bug repellant often. Ultimately, however, scanning the skin once again saved the day and we can tick off another reason for remaining alert to the new and unusual.

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About Steve P. Sanders

A general internist writing and sharing ideas and art.

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