牛痘1例

患者男,27岁.因右手水疱、脓疱,伴肿胀10余天,于2010年2月20日就诊于我科.患者2周前不慎被牛咬伤右手拇指掌指关节处,未处理.10 d前,在咬伤部位出现豆大水疱伴有发热,体温37.8 ℃.当地医院给予外用消炎药膏(具体药物不详),口服氢化可的松120 mg/d.用药3 d后热退,但皮损无明显好转.7 d前在同一侧手中指掌指关节、无名指、小鱼际肌外侧缘、前臂下1/3尺侧缘出现同样的皮损.     

大疱性Sweet综合征伴原发性血小板增多症一例

患者,女,51岁,汉族。因间断高热16天,右足水肿伴大疱7天,于2017年4月17日就诊。患者16天前无明显诱因出现间断高热,峰值为40.5℃,伴左大腿内侧肿胀疼痛（图1）,7天前右足背及外踝开始出现肿胀伴新发大疱（图2）。患者既往合并原发性血小板增多症,规律口服羟基脲0.5 g,日2次治疗,入院前1周因发热在当地血液科医生指导下停药。病程中患者持续高热,入院后第2日左足背出现红色斑疹。否认传染病史及药物过敏史,家族中无类似患者,否认家族恶性肿瘤史。     

药物超敏反应综合征1例

<正>1临床资料患者女,45岁。全身皮肤潮红、肿胀和脱屑伴瘙痒及发热半月。40天前,因腰椎间盘突出伴疼痛口服风湿消骨镇痛灵(青岛永康药业)及骨刺消痛液(北京同仁堂)20余天。半月前面部出现红斑和丘疹,后累及躯干和四肢,当地医院以"过敏性皮炎?"予     

蜱叮咬1例报告

蜱又名扁虱,分软蜱和硬蜱两大类,常叮咬狗、牛、马,偶尔叮咬人,主要流行于美国、欧洲和澳洲等地,国内亦有发现［１］。我们见到１例硬蜱叮咬人体并在体表寄生长达４天的患者,现报告如下。患者男,２３岁。因左腋下红肿伴附着物４天来诊。４天前患者在河北雾灵山旅游...     

无花果叶致急性光毒性接触性皮炎1例

1 临床资料 患者女,15岁.面部、双手及足部水肿性红斑、水疱,伴瘙痒3天.3天前患者用无花果叶煎水洗澡治疗皮肤瘙痒,浴后晒太阳近2h,当晚面部、双手及足部皮肤出现红斑,伴瘙痒,继之肿胀.出现水疱,瘙痒加剧.既往无光感性过敏及药物过敏史.     

腮腺炎致多形红斑一例

临床资料患儿,男,9岁。因发热1周,皮疹伴腮部肿胀2天,于2013年12月27日入院。患儿1周前出现发热,最高体温39.4℃,伴咳嗽,2天前出现面部及躯干四肢红色斑丘疹,逐渐增多,伴瘙痒,并出现眼红,有脓性分泌物,口唇糜烂、皲裂,左侧腮部肿胀疼痛,伴脐周隐痛,无头痛、呕吐、呼吸困难,在当地医院输液治疗无好转,遂至我院,     

氨苯砜综合征2例

1临床资料 病例1 患者女,20岁,因面、躯干、四肢红斑、丘疹、肿胀、瘙痒伴发热10天,于2000年1月11日入院.患者于入院前5周因种痘样水疱病口服氨苯砜75 mg/d,入院前3周减至50 mg/d,入院前10天面部、躯干、四肢出现红斑、丘疹、肿胀、瘙痒伴发热.     

急性泛发性发疹性脓疱病1例

患者李某,女,28岁,因“全身皮疹伴疼痛2天”于2000年5月人院。患者入院前2天因双手臂出现数粒粟粒大小红色皮疹伴瘙痒在外院拟“皮炎”予林可霉素静脉滴注,数小时后全身皮肤出现潮红、肿胀伴烧灼样疼痛,在该院经苯海拉明、葡萄糖酸钙等治疗,症状无改善,疼痛加剧,遂到我院门诊就诊,拟“药疹”收入院。患者发病以     

大疱性系统性红斑狼疮1例

临床资料患者男,24岁.因发热咳嗽4天、恶心呕吐2天于2007年5月24日入住我院血液科.入院前4天出现发热(39～40℃)、阵发性轻度咳嗽伴少量稀薄白色痰液,于当地医院静脉点滴抗生素及退热药(药名不详)效果不佳,同时发现血细胞低于正常,遂来我院就诊,入院前2天患者出现恶心呕吐伴精神不振和食欲下降.     

界线类偏瘤型麻风1例

<正>患者,女,61岁,农民。全身皮肤起丘疹、红斑、结节,双手、足麻木、肿胀、疼痛40余天。2013年3月1日患者面部、左上肢出现10余个丘疹,逐渐增大,伴轻微痒感。在村卫生室拟"过敏性皮炎"治疗3天(具体药物不详),无效。10天后,皮损累及双下肢,并出现双侧手、足麻木、肿胀及疼痛感,就诊于县人民医院风湿科,拟"风湿性关节炎"收入院治疗6天(药物不详),手、足肿胀消退,皮疹有所减轻。出院后第2天,又出现手、足肿胀,腰部亦发生数个结节并伴低热,2014年4月16日就诊于我院。     

Cutaneous histopathology of the tick‐bite region in severe fever with thrombocytopenia syndrome

A case of severe fever with thrombocytopenia syndrome (SFTS) in which a skin biopsy from the tick‐bite region was analyzed is reported. The patient was a 72‐year‐old woman who developed fever and thrombocytopenia after a tick bite. SFTS was diagnosed from polymerase chain reaction (PCR) analysis of a blood sample. Histopathological analysis of a skin biopsy specimen from the tick‐bite region showed CD20‐positive perivascular and interstitial immunoblastic cells, which were positive to anti‐SFTS virus (SFTSV) nucleoprotein antibody. In addition, SFTSV RNA was detected by real‐time PCR from this biopsy specimen. Moreover, hemophagocytosis was also found in the tick‐bite region. To the best of our knowledge, this is the first report to analyze the details of the tick‐bite region of skin in SFTS, and the first to detect virus‐infected cells in the skin. The present findings may help elucidate the mechanisms of entry of SFTSV.     

Laboratory observations of Haemaphysalis longicornis Neumann after a human bite

A case of a tick bite with Haemaphysalis longicornis Neumann is reported. The tick was found on the left lower abdomen of a 62-year-old female. The tick bite occurred in Fuchu city, a suburb of Tokyo. This paper presents laboratory observations of the process of Haemaphysalis longicornis Neumann laying eggs and becoming larvae after biting a human. The results of our observations include the size of female adult (length: 7.5 mm, width: 5.2 mm, weight: 96 mg) after blood sucking, preoviposition period (7 days), oviposition period (24 days), number of eggs (760 eggs), egg size (length: 0.58-0.62 mm, width: 0.39-0.42 mm), size of unfed larva (length: 0.45-0.5 mm, width: 0.45-0.5 mm) and unfed larva period until death, which ranged from 10 days to 62 days.     

Tick bite by Haemaphysalis megaspinosa - first case

We describe the first case of tick bite by Haemaphysalis megaspinosa. The tick was found on the skin at the right occipital area in a 5-year-old girl, who had gone on a picnic twice to a mountain 1 and 5 days before she noticed the tick. The tick was surgically removed. The tick was identified as an adult female of Haemaphysalis megaspinosa from its morphological characteristics. This is the first report of tick bite by Haemaphysalis megaspinosa.     

Case of tick‐associated rash illness caused by Amblyomma testudinarium

We report a case of tick‐associated rash illness (TARI), a new clinical entity of erythema migrans associated with a tick bite without infection of Lyme borreliosis agent. The patient, a 53‐year‐old man, went hiking in a mountainous area of Minoh City, Osaka Prefecture in October 2012. An erythematous macule with itching and a biting tick was found on his left thigh 2 days later, which gradually expanded. On the first visit to our department at the fifth day after hiking, an erythematous macule of 10 cm was recognized around the bite site. He had no systemic symptoms, and laboratory data were within normal limits. The tick was identified as a nymph of Amblyomma testudinarium. Histopathologically, perivascular infiltrates, mainly consisting of T lymphocytes, were seen in the dermis. The skin rash disappeared within 2 weeks with no treatment. Serum antibody titers against Lyme disease borrelial and rickettsial agents on the first visit and 2 weeks later were negative. These results indicate that the skin lesion of TARI was not associated with borrelial or rickettsial infection but a T‐cell‐mediated allergic reaction to salivary gland substances of the tick.     

Persistent atypical lymphocytic hyperplasia following tick bite in a child: report of a case and review of the literature

We report a 6-year-old girl who developed a red papule on the posterior neck at the site of a previous tick bite. Initial biopsy was performed a year after the bite and the specimen showed a dense lymphoid infiltrate with admixed CD30+ cells. The patient was referred to our center because of concern about the development of a CD30+ lymphoproliferative disorder. The lesion was completely excised. Histology showed no evidence of a clonal lymphoproliferative disorder or Borrelia infection, but persistence of CD30+ cells. This case demonstrates that a tick bite reaction can persist for more than 1 year and show immunophenotypic and morphologic overlap with a CD30+ lymphoproliferative disorder. Complete history with thorough clinical and histopathologic evaluation is necessary to arrive at the correct diagnosis.     

A Case of Tick Bite from Amblyomma testudinarium on the Glans Penis

A tick which bit the glans penis of a 40-year-old Japanese man was surgically excised together with the skin where the bite occurred. It was identified as Amblyomma testudinarium through the taxonomical investigation of its morphological characteristics. To our best knowledge, our patient is the sixth tick bite from this species of tick recorded in the Chugoku District of Japan.     

African tick bite fever: a not-so-uncommon illness in international travelers

BACKGROUND: African tick bite fever is a rickettsial illness that has recently emerged as a significant disease among international travelers. The vector is the Amblyomma tick, which is endemic to sub-Saharan Africa and parts of the eastern Caribbean. OBSERVATIONS: We describe a middle-aged woman who returned from a mission trip to Zimbabwe with an influenzalike illness and inoculation eschar; she also had a history of travel to a game farm. Biopsy revealed a histopathologic pattern consistent with an infectious pathogenesis. Immunohistochemical staining confirmed the presence of rickettsial organisms. In light of the patient's history, the clinical constellation of signs and symptoms, and the results of ancillary laboratory testing, a diagnosis of African tick bite fever was made. The patient was treated with doxycycline hydrochloride and had an uncomplicated course. CONCLUSIONS: This report further highlights the epidemiological and clinical features of African tick bite fever. With the increase in international travel, it is important to recognize the illness in those who have been to endemic countries and to counsel patients regarding preventive measures for planned travel.     

A case of tick-bite from Ixodes ovatus Neumann--a report from west Japan

A 70-year-old male forestation worker had a tick-bite on the lower abdominal skin. The bite was treated by surgical excision of the tick together with the surrounding skin. The tick was identified as Ixodes ovatus Neumann through investigation of its morphological characteristics. This patient is the fourth case of a tick-bite from Ixodes ovatus Neumann in western Japan.     

A case of tick bite with Ixodes turdus Nakatsuji--a report from Japan

The first case of tick bite by Ixodes turdus Nakatsuji was reported. The tick was found on the occipital area near the left ear of a 6-year-old boy. The tick bite occurred in Hoya, a suburb of Tokyo.     

Eosinophilic cellulitis (Wells' syndrome): histologic and clinical features in arthropod bite reactions

Five patients are described with the clinical and histopathologic picture, including flame figures, of eosinophilic cellulitis (Wells' syndrome). Two of them had documented tick bites in the center of these expanding annular lesions, and the histologic picture showed the diagnostic flame figures of Wells' syndrome (eosinophilic cellulitis). A third patient had a clinical picture suggestive of a tick bite reaction but stated she was stung by a small garden bee at the involved site. The fourth patient removed a spider from the site of a spider bite, and this nodule also histopathologically was identical to that of eosinophilic cellulitis. Our fifth patient presented with papular urticaria of flea bites. We suggest that the characteristic flame figures of eosinophilic cellulitis (Wells' syndrome) are not diagnostic of a specific disease entity but rather a striking and peculiar histopathologic response to multiple factors of which arthropod bites (ticks, bees, fleas, and spiders) represent one definite etiology.