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December 1972


Arch Dermatol. 1972;106(6):916-918. doi:10.1001/archderm.1972.01620150094030

Tick Bite Granuloma With Autoeczematization. Presented by Donald R. Shasky, MD.  A 42-year-old white housewife was bitten by a tick on her left thigh and knee in May 1971 in Alabama. The lesions persisted and, subsequently, in June 1971 she developed similar ones over the left arm and forearm. After therapy with chloramphenicol, tetracycline, and prednisone, 20 mg daily, for 14 days from her family physician, all the areas subsided except for induration and numbness in the left thigh. When therapy was discontinued, the lesions recurred and became eczematized.

Discussion  Dr. Leo Indianer: In the stratum corneum were polymorphonuclear abscesses and there is extensive pseudoepitheliomatous hyperplasia. There was a tremendous granulomatous, inflammatory reaction in the dermis. The infiltrate contained eosinophiles, lymphocytes, histiocytes, proliferating vessels, and degenerative nuclei. The inflammatory cells extended into the epidermis, where there was spongiosis. While there were some foreign body giant cells, I could not see