Contact dermatitis on the lower eyelid related to tick infestation A case report in Taiwan.pdfVIP

Taiwan Journal of Ophthalmology 6 (2016) 201e203 Contents lists available at ScienceDirect Taiwan Journal of Ophthalmology journal homepage: Case report Contact dermatitis on the lower eyelid related to tick infestation: A case report in Taiwan Yun-Hsuan Lin a, Ling Yeung a, b, Chi-Chin Sun a, b, Wan-Chen Ku a, Ju-Wen Yang a, b, * a Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan b College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan article info Article history: Received 3 February 2016 Received in revised form 18 May 2016 Accepted 20 May 2016 Available online 16 July 2016 Keywords: Ticks Tick bites Tick infestations Contact dermatitis Eyelids abstract Tick bite on the lower eyelid is a rare condition. We reported a case of contact dermatitis on the lower eyelid related to the tick infestation. Ticks are vectors for disease transmission. Symptoms and treatments for tick-borne diseases were reviewed. Copyright ? 2016, The Ophthalmologic Society of Taiwan. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (/licenses/by-nc-nd/4.0/). 1. Introduction Tick infestation of the lower eyelid is a rare condition but one that requires close observation for the development of erythema migrans. We report a case of a skin rash on the lower eyelid that occurred after a tick bite and review the literature. This study received Institutional Review Board approval from the Ethics Committee at Chang Gung Memorial Hospital (Keelung City, Taiwan). 2. Case Report A 50-year-old Taiwanese woman presented to our clinic with a right lower eyelid pigmented nodule associated with cheek tingling, pain, and numbness for 1 week. She reported a history of hiking 1 week before presentation. During the examination, a tick was found on the right lower eyelid skin, and its waste was visible around the eyelashes (Figure 1). The tick was removed using ?ne forceps and gentle scraping with cotton swabs; however, 1 mo