Tick Bites - the View from Inside-Out

The tick feeding process in humans and its local effects have been studied histologically and in reflection microscopy on specimens of skin lesions, and on tick samples. The mouthparts of the attached ticks, embedded in a cement cone, lined the oral canal. The pharynx was supplied with anti-reflux valves and dilating muscles. The dermis around the mouthparts was, characteristically, replaced by a lose network of fibrin, endothelia, and collagen fibers, soaked with edema and blood, with a dense neutrophilic infiltrate beneath the cone. The vessels showed interruptions, with blood extravasation, endothelial proliferation, and vasculitis. After the tick removal, Erythema Chronicum Migrans–like patches, foreign body granuloma, T- and the B-cell lymphoid hyperplasia, and alopecia areata –like hair loss were recognized.