2019 Volume 18 Issue 6 Pages 360-365
A 33-year-old Japanese man went hiking in a mountainous area in France in August. He noticed a tick with itching on his waist and felt slight fatigue several days later. He returned home and visited the Department of Dermatology of Nippon Life Hospital. At the rst visit, a blood sucking tick was found on his waist, but erythema migrans was not found around the bitie site. Laboratory tests revealed a slight increase in serum levels of liver enzymes and c-reactive protein. The tick was removed with the surrounding skin under local anesthesia and the patient was administered 750 mg/day of tetracycline hydrochloride for 14 days. Two months later, the patient consulted the Department of Dermatology of Hyogo College of Medicine for examination of the tick and tick-borne infectious diseases. The tick was identied as an adult Ixodes ricinus female and serum IgM antibodies to Lyme disease were positive. Based on these results, we diagnosed him with Lyme disease caused by the tick bite in France. Early antibiotic therapy may have prevented aggravation of the disease in the present case. Dermatologists in Japan should pay attention to Lyme disease due to Ixodes tick bites in patients who visited Europe or North America. Skin Research, 18 : 360-365, 2019
