Tick bites are common in the United States and are vectors for several serious systemic diseases, including Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and tularemia. These diseases are discussed elsewhere in this text.
The bite of a tick is usually painless. It may become pruritic over time. Through the mouth parts, the tick cements itself to the skin to obtain a blood meal. As a result, ticks are difficult to remove from the skin. A tick can be recognized as a dark-brown to black organism firmly adherent to the skin. It enlarges as its body becomes engorged with the host's blood. The best approach to removing a tick is to grasp it with tweezers as close to the skin as possible and gently pull with steady pressure. Methods such as burning the tick with a flame, pouring alcohol on it, or covering it with petroleum jelly will not dislodge the tick. If the entire tick is not removed, the patient may develop a foreign-body reaction, which is best treated by excision of the area.
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