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Dermatology Practice Today

Visual Dermatology Clinic: Deer Tick

Published June 26, 2014 2:15 PM by Amy Gouley

66 year old Male presented for a "skin tag" on his left posterior leg for 2-3 weeks. Patient denies pain but does report some tenderness when it brushes the sheets of his bed.
Upon examination was these photos:


A 6mm punch bx was performed and the insect was sent for identification.
The lab identified the tick as an Adult female deer tick (Ixodes scapularis). The patient then opted to pay $110 for 3 Pathogen Tick Panel which included:

Negative for Borrelia burgdorferi (the causative agent of Lyme Disease).

Negative for Anaplasma phagcytophilum (the causative agent of Human Granulocytic Anaplasmosis).

Negative for Babesia microti (the causative agent of Babesiosis).

DNA is extracted from the tick and the polymerase chain reaction (PCR) is performed using real time PCR detection time.

Interestingly, we are unsure about the tick's origin. The patient hikes on a daily basis here in Washington State, but reported hiking in upstate New York 3 weeks prior.

A fantastic website for the most current information of Lyme Disease is the International Lyme And Associated Diseases Society:


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About this Blog

    Occupation: Physician assistant and nurse practitioners
    Setting: Various dermatology settings
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