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RICKETTSIALPOX
RICKETTSIALPOXย ย ICD-10: A79.1
โข Epidemiology. R. akari. Vector: Mice mite (Liponyssoides sanguineus), other mites; transovarian transmission. Geography: United States, Europe, Russia, South Africa, Korea, and Europe.
CLINICAL MANIFESTATION
Tรขche noire (Fig. 25-53). At tick bite site. EXANTHEMโ2 to 6 days after the onset of nonspecific symptoms, red macules and papules appear. May evolve to characteristic vesicles (pox); crusted erosions occur. Lesions usually heal without scarring.
COURSE
Fever resolves in 6 to 10 days without treatment with doxycycline.
DIFFERENTIAL DIAGNOSIS
Viral exanthems, varicella, and pityriasis lichenoides et varioliformis acuta.

FIGURE 25-53 โข Rickettsialpox: Tรขche noireโA crusted, ulcerated papule (eschar) with a red halo resembling a cigarette burn at the site of a tick bite.