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 (firstname.lastname@example.org).
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.
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.
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).
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