We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Multiple Bites From the Larvae of Haemaphysalis longicornis

Young Bok Lee, MD; Jae Bok Jun, MD; Jun Young Kim, MD; Baik Kee Cho, MD; Hyun Jeong Park, MD
Arch Dermatol. 2011;147(11):1333-1334. doi:10.1001/archdermatol.2011.328.
Text Size: A A A
Published online


Correspondence: Dr Park, Department of Dermatology, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, 62 Yeouido-dong, Youngdeungpo-ku, Seoul, 150-713 Korea (hjpark@catholic.ac.kr).

Financial Disclosure: None reported.

Funding/Support: This work was supported by grant 2011-0001390 from the National Research Foundation (NRF) of Korea funded by the Korean government (Ministry of Education, Science and Technology) and Basic research program grant 2010-0002431 through the NRF also funded by the Ministry of Education, Science and Technology.

Role of the Sponsors: The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript.

Figures in this Article


bite ; larva

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Tick bites and ticks seen on the study patient. A, Multiple erythematous papules observed on the lower abdomen; the inset shows a tiny brown organism observed at the center of an individual papule. B, In the larva of Haemaphysalis longicornis, the capitulum has a short corn-shaped hypostome; the scutum, anus, and festoon are also seen. Coxa I has a broad triangular spur; coxae II and III have a slightly elevated ridge in place of the spur. The asterisks indicate the coxae, or points of joint attachment of the legs to the body. The arrow indicates the hypostome, showing a 2/2 dental formula describing the arrangement of toothlike bumps.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. The biopsy specimen shows that the larva penetrated the epidermis and consumed red blood cells. There was no cavity formation or remaining mouth part in the dermis. The infiltrated cells in the upper dermis were mostly eosinophils and extravasated red blood cells (hematoxylin-eosin, original magnification ×200).




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles