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Insects of the genus Lipoptena, e.g., Lipoptena cervi and Lipoptena fortisetosa, are hematophagic ectoparasites mainly attacking deer, roe deer, moose, horses, and cattle. Humans may also be incidental hosts for these insects. The species are vectors of numerous pathogens, including Bartonella schoenbuchensis, Borrelia burgdorferi, and Anaplasma phagocytophilum. Due to the short time of feeding on humans, usually painless bites, and an initially small trace at the site of the bite, the symptoms reported by the patient may not be associated with deer ked infestation and infection with pathogens transmitted by these arthropods. The aim of the study was to describe the consequences of L. cervi bites in humans with detailed documentation of the development of skin lesions. The knowledge about skin lesions arising after deer ked bites may be useful in clinical practice for monitoring patients for the presence of pathogens transmitted by the parasites. Full article

Background: The territorial expansion and increased population size of haematophagous arthropods (i.e., the castor bean tick Ixodes ricinus (Ixodida: Ixodidae) and the deer ked Lipoptena cervi (Diptera: Hippoboscidae)) has enhanced the risk of human infestations in Europe. The aim of our study was to present skin lesions induced by tick and deer ked bites in patients from recreational forest regions in southeastern Poland and pay attention to features of skin changes that may be useful in differential diagnosis. Methods: We compare the skin lesions after I. ricinus and L. cervi bite and draw attention to the biological and ecological traits of both ectoparasites, which may be diagnostically relevant for determination of the cause of skin symptoms reported by patients. Results: I. ricinus bites lead to development of erythematous-infiltrative poorly demarcated lesions with a centrally located bite mark, which usually disappears within one to several days. In turn, L. cervi bites leave irregularly shaped scattered erythematous papules. The papules may persist for up to one year and are accompanied by itching. Conclusions: Correct assessment of the clinical picture and its association with an arthropod bite (e.g., tick or deer ked) is highly important for further diagnostic procedures (i.e., differentiation of skin lesions developing in tick-borne diseases and, consequently, correct choice of pharmacological therapy). I. ricinus and L. cervi differ in their developmental cycles and rhythms of activity, which indicates that both species should be considered potential causative agents in the differential diagnosis of skin lesions when the patient has been bitten by an arthropod in autumn and winter months. Full article