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Tick Bite Alopecia: A Report and Review.

Michael C Lynch1, Marissa A Milchak, Herbert Parnes

  • 1*Department of Pathology, Penn State College of Medicine, The Penn State Hershey Medical Center, Hershey, PA; †Penn State College of Medicine, The Penn State Hershey Medical Center, Hershey, PA; and ‡Department of Dermatology, Penn State College of Medicine, The Penn State Hershey Medical Center, Hershey, PA.

The American Journal of Dermatopathology
|April 21, 2016
PubMed
Summary

A tick bite can cause nonscarring alopecia, a rare condition characterized by inflammation and hair loss. This case report highlights the first adult diagnosis of this tick-induced hair loss.

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Area of Science:

  • Dermatology
  • Pathology
  • Entomology

Background:

  • Tick bites can manifest with diverse inflammatory skin reactions, often mimicking other arthropod-induced lesions.
  • Differentiating tick bite reactions from other causes is clinically challenging.
  • Reported reactions include erythematous lesions, erythema chronicum migrans, and inflammatory alopecia (scarring and nonscarring).

Observation:

  • A 21-year-old male presented with nonscarring alopecia following a reported tick bite on the scalp.
  • Scalp biopsy revealed a dense pseudolymphomatous inflammatory infiltrate rich in eosinophils.
  • Histological findings included hair follicle miniaturization and an increased catagen-telogen hair count.

Findings:

  • The biopsy also showed signs of pruritus, such as lichen simplex chronicus and the "hamburger sign".
  • This represents the fifth reported case of nonscarring tick bite alopecia and the first documented in an adult.
  • The findings suggest a specific inflammatory response to tick bites leading to temporary hair loss.

Implications:

  • This case expands the known spectrum of tick bite-induced dermatological conditions.
  • Understanding the clinical and histological features is crucial for accurate diagnosis and management.
  • Further research into the pathogenesis of tick bite alopecia is warranted to elucidate the underlying mechanisms.