DermAtlas: Online Dermatology Image Library dermatology image,wood tick,Rocky Mountain spotted fever,purpura fulminans,vasculitis

© 2001-2009, DermAtlas	*Image Name:*	woodtick_1_010728	*File Type:*	jpg
	*Diagnosis:*	WOOD TICK / ROCKY MOUNTAIN SPOTTED FEVER	*Category:*	demonstration / infections and infestations
	*Body Site:*		*Age:*	0
	*Contributor:*	Bernard Cohen, MD
	*Description:*	Large (8 m body) 8-legged arachnid; black with brown leather pattern on body and legs
	*Comments:*	In the United States the most common vectors of Rickettsia rickettsii include Dermacentor variabilis (American dog tick), Dermacentor andersoni (wood tick), and Amblyomma americanum. The adults are active feeders from April to October, and the risketsia e can be transmitted by a bite from an infected tick or contamination of the skin when the tick is being removed or crushed. See clinical images of Rocky Mountain spotted fever in dermatlas.com.

© 2001-2009, DermAtlas	*Image Name:*	rmsf_5_010907	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER / PURPURA FULMINANS	*Category:*	purpura / infections and infestations / reactive erythema
	*Body Site:*	arm	*Age:*	3 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	diffuse petechiae and edema
	*Comments:*	An ill appearing toddler with high fever and a diffuse red rash and edema suddenly developed diffuse petechiae and ecchymoses. Laboratory studies showed a prolonged bleeding time, thrombocytopenia, anemia, and neutropenia. After a prolonged course in the pediatric intensive care unit, he recovered uneventfully with the exception of necrosis of the tips of several toes.

© 2001-2009, DermAtlas	*Image Name:*	rmsf_4_010907	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER	*Category:*	infections and infestations / reactive erythema
	*Body Site:*	palm / hand thigh	*Age:*	33 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	subtle red macules
	*Comments:*	This 9 year old boy developed a red partially blanching papular eruption on his hands and feet including his palms and soles that progressed to the trunk over 3 days. He had a severe headache, high fever, arthralgias and myalgias. His mother, who remembered removing a wood tick from her son's scalp 10 days earlier also developed a rash, fever, and headache.
	*Related Images:*	All related Images rmsf_1_010907 rmsf_2_010907 rmsf_3_010907

© 2001-2009, DermAtlas	*Image Name:*	rmsf_3_010907	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER	*Category:*	infections and infestations / reactive erythema
	*Body Site:*	knee	*Age:*	9 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	red partially blanching papules
	*Comments:*	This 9 year old boy developed a red partially blanching papular eruption on his hands and feet including his palms and soles that progressed to the trunk over 3 days. He had a severe headache, high fever, arthralgias and myalgias. His mother, who remembered removing a wood tick from her son's scalp 10 days earlier also developed a rash, fever, and headache.
	*Related Images:*	All related Images rmsf_1_010907 rmsf_2_010907 rmsf_4_010907

© 2001-2009, DermAtlas	*Image Name:*	rmsf_2_010907	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER	*Category:*	infections and infestations / reactive erythema
	*Body Site:*	hand / palm	*Age:*	9 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	red partially blanching papules
	*Comments:*	This 9 year old boy developed a red partially blanching papular eruption on his hands and feet including his palms and soles that progressed to the trunk over 3 days. He had a severe headache, high fever, arthralgias and myalgias. His mother, who remembered removing a wood tick from her son's scalp 10 days earlier also developed a rash, fever, and headache.
	*Related Images:*	All related Images rmsf_1_010907 rmsf_3_010907 rmsf_4_010907

© 2001-2009, DermAtlas	*Image Name:*	rmsf_1_010907	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER	*Category:*	infections and infestations / reactive erythema
	*Body Site:*	foot / leg	*Age:*	9 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	red partially blanching papules
	*Comments:*	This 9 year old boy developed a red partially blanching papular eruption on his hands and feet including his palms and soles that progressed to the trunk over 3 days. He had a severe headache, high fever, arthralgias and myalgias. His mother, who remembered removing a wood tick from her son's scalp 10 days earlier also developed a rash, fever, and headache.
	*Related Images:*	All related Images rmsf_2_010907 rmsf_3_010907 rmsf_4_010907

© 2001-2009, DermAtlas	*Image Name:*	rmsf_4_010609	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER / VASCULITIS	*Category:*	infections and infestations / purpura
	*Body Site:*	foot	*Age:*	8 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	symmetric red papules and edema
	*Comments:*	This 8 year old boy from Maryland developed severe headache, fever, widespread red papules.and other flu-like symptoms during the summer. The rash was most prominent on the extremities where there was also some subtle non-pitting edema. He was slightly neutropenic and hyponatremic. He spent hours in the woods near his house, but did not remember being bitten by a tick. Skin biopsy showed a vasculitis, and immunoperoxidase studies were positive for Rocky Mountain spotted fever. He was better after 36 hours of doxycycline.

© 2001-2009, DermAtlas	*Image Name:*	rmsf_3_010609	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER / VASCULITIS	*Category:*	purpura / infections and infestations
	*Body Site:*	foot	*Age:*	4 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	necrotic star shaped purpuric papules
	*Comments:*	In May a 4 year old boy from Maryland developed fever, headache, vomiting, neck stiffness, and a widespread palpable purpuric eruption especially on the extremities. His mother noted pulling ticks from his body on multiple occasions durimg the preceding month. A skin biopsy showed a vasculitis, and immunoperoxidase studies were positive for Ricketsia ricketsii. Although he was hypotensive at presentation, he improved quickly on doxycycline.

© 2001-2009, DermAtlas	*Image Name:*	rmsf_2_010609	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER / VASCULITIS	*Category:*	purpura / infections and infestations
	*Body Site:*	foot / sole	*Age:*	9 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	purple non-blanching papules
	*Comments:*	A 9 year old girl from Maryland developed a palpable purpuric eruption on her distal extremities including her palms and soles. Her mother remembered removing a tick from her back 1 week earlier. She complained of fever, malaise, and severe headache. Skin biopsy of 1 of the papules showed a vasculitis and immunoperoxidase studies of the tissue were positive for Ricketsia ricketsii
	*Related Images:*	rmsf_1_010609

© 2001-2009, DermAtlas	*Image Name:*	rmsf_1_010609	*File Type:*	jpg
	*Diagnosis:*	ROCKY MOUNTAIN SPOTTED FEVER / VASCULITIS	*Category:*	purpura / infections and infestations
	*Body Site:*	hand / palm	*Age:*	9 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	violaceous non-blanching papules
	*Comments:*	A 9 year old girl developed a palpable purpuric eruption on her distal extremities including her palms and soles. Her mother remembered removing a tick from her back 1 week earlier. She complained of fever, malaise, and severe headache. Skin biopsy of 1 of the papules showed a vasculitis and immunoperoxidase studies of the tissue were positive for Ricketsia ricketsii
	*Related Images:*	rmsf_2_010609

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© DermAtlas, Johns Hopkins University; 2000-2009
Bernard A. Cohen, MD, Christoph U. Lehmann, MD
DermAtlas was last updated: Oct-28-2009
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