title: Tick mouth parts occlusive vasculopathy: a localized cryoglobulinemic vasculitic response.
abstract: BACKGROUND
  The histologic hallmark of most arthropod bite reactions is a deep, wedge-shaped perivascular and interstitial infiltrate comprising lymphocytes, neutrophils, and eosinophils.
  
  
  METHODS
  We present a case series of six patients in whom tick bite reactions, when examined microscopically, were found to mimic mixed cryoglobulinemic vasculitis.
  
  
  RESULTS
  Though different in histology, clinically these lesions were indistinguishable from typical tick bite reactions.
  
  
  CONCLUSIONS
  As five of our six biopsy specimens were found to still harbor retained tick parts, it is possible that the actual retention of tick parts was involved in evoking this localized cryoprecipitate reaction.
authors.affiliation: Department of Dermatology, Strong Memorial Hospital, Rochester, NY, USA. ngalaria@hotmail.com
authors.forename: Noreen A
authors.initials: NA
authors.lastname: Galaria
authors.forename: Omer
authors.initials: O
authors.lastname: Chaudhary
authors.forename: C M
authors.initials: CM
authors.lastname: Magro
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D003449:Cryoglobulinemia / Q000150:complications / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology*; D013987:Ticks / Q000472:pathogenicity*; D014657:Vasculitis / Q000150:complications / Q000473:pathology*