Hard tick in female external genitalia: A rare site of tick bite

Ticks are principal vectors for the transmission of numerous arthropod-borne infections like Lyme disease, human granulocytic anaplasmosis, babesiosis, viral encephalitis, Borrelia, and rickettsial infections. Rarely, tick infestation of lower eyelid has been reported. So far, there has been no case report about tick infestation in genitalia. Hence, we report this rare case entity. A 55-year-old married postmenopausal female reported to the skin OP with the complaints of itching over external genitalia for 3 days. Local examination of the external genitalia initially revealed a hyperpigmented papule over the left labium majus. However, on careful examination, we could see an alive insect burying its head into the skin, and body protruding out with moving legs among the pubic hairs over left labium. At the base of attachment of the insect, there was a small indurated swelling. The tick was carefully removed intact with plain forceps without crushing. After removal, the intact tick was confirmed by the entomologist, as a hard tick of Ixodidae family. Hard tick infestation in animals is common. As hard tick infestation is very rare in covered sites that too in external genitalia, we report this case.