Skin manifestations of tick bites in humans

Abstract

Ticks are blood-sucking arthropods that attach to human skin through oral devices causing diverse initial cutaneous manifestations, and may also transmit serious infectious diseases. In certain situations, the Health Teams (and especially dermatologists) may face difficulties in identifying the lesions and associating them to the parasites. To assist them in clinical diagnosis, we suggest a classification of the skin manifestations in primary lesions, which occur by the attachment the tick to the host (for toxicity and the anticoagulant substances in the saliva and/or marked inflammation by the penetration and permanence of the mouthparts) and secondary lesions that are manifestations of infections caused by rickettsia, bacteria, protozoa and fungi inoculated by the ticks.

Allergic Reactions and Immunity in Response to Tick Salivary Biogenic Substances and Red Meat Consumption in the Zebrafish Model

“…Considering that zebrafish are evolutionarily naive to tick saliva as they are not naturally exposed to ticks, the observed allergic hemorrhagic anaphylactic-type reactions and abnormal behavior patterns may occur in response to toxic and anticoagulant biogenic compounds different from α-Gal and PGE 2 present in tick saliva (Francischetti et al, 2009;Aleman and Wolberg, 2013;Mihara, 2017;Stringer et al, 2017;Haddad et al, 2018). For example, although uncommon, episodic hemorrhage has been described in humans during honeybee venom anaphylaxis (Mingomataj and Bakiri, 2012).…”

“…Arthropod ectoparasites are a growing burden worldwide (Stutzer et al, 2018). Local allergic reactions to the bite of arthropod ectoparasites such as mosquitoes, ticks, fleas, mites, and lice are common, but in some cases large local and anaphylactic reactions are possible (Lee et al, 2016;Mihara, 2017;Stringer et al, 2017;Haddad et al, 2018;Ha et al, 2019).…”

“…Tick saliva contains multiple biomolecules such as proteins and lipids that facilitate feeding while counteracting host defense responses, properties that also lead to possible application of these molecules in therapeutic interventions (Chmelar et al, 2019). However, tick bites themselves can induce a spectrum of inflammatory reactions in response to toxic and anticoagulant biogenic substances present in tick saliva and/or mouthpart penetration such as coagulative necrosis producing firm papules, tick paralysis, intense pruritus, tick bite alopecia, cutaneous lymphoid hyperplasia, and cell histiocytosis (Mihara, 2017;Stringer et al, 2017;Haddad et al, 2018;Ha et al, 2019). Additionally, tick bites can induce in humans high levels of immunoglobulin E (IgE) antibodies against the carbohydrate Galα1-3Galβ1-(3)4GlcNAc-R (α-Gal) present in glycoproteins and glycolipids from tick saliva that mediate delayed anaphylaxis to red meat consumption, and immediate anaphylaxis to tick bites, xenotransplantation, and certain drugs such as cetuximab (Mateos-Hernández et al, 2017;Hilger et al, 2019).…”

Acute Tick Bite (Acari : Ixodidae)

“…They are obligate hematophagous ectoparasites . Ticks are divided into three major families, the Ixodidae/hard tick, and the Argasidae/soft tick and the Nuttalliellidae [8] (Nuttalliellidae is not much of medical importance) . In the case of ixodid ticks, it is usually the parasite itself that attracts the patient's attention.…”

Is Mycetoma a Vector-Borne Disease: The First Report on the Detection of Madurella mycetomatis in Ticks

“…The primary one is caused by the attachment the tick to the host skin leading to severe skin inflammatory reaction due to the saliva anticoagulant substances and due to the penetration and permanence of the ticks’ mouthparts. The secondary lesions are due to the infections caused by rickettsia, bacteria, protozoa and fungi inoculated by the ticks [30]. From all these facts, we can then extrapolate that ticks mechanically can transmit mycetoma causative organism specifically under poor hygiene.…”