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A 46-year-old man presented to the emergency department having noticed in the shower that morning an itchy black spot with some surrounding erythema on his genitals. Further enquiry revealed he had been enjoying the summer heat in shorts while walking in Hutt Wood, Southampton, the day before. Examination revealed a 2 mm live tick burrowed in the dorsum of his penis (figs 1 and 2). The tick was removed with splinter forceps and the patient was prescribed chloramphenicol ointment for local use. The Microbiology Reference Laboratory identified the insect as a wood tick (Dermacentor variabilis). Vaseline and dressings are thought to be ineffective in removing the mandible; caustic applications can damage surrounding skin.
Acknowledgments
This article has been adapted from Utting David, Harrison Nigel. Wood tick Emergency Medicine Journal 2007;24:736