Tick-borne diseases are increasing in prevalence. Ticks are best removed as soon as possible, because the risk of disease transmission increases significantly after 24 hours of attachment.1 Furthermore, signs and symptoms of tick paralysis improve within hours of tick removal, and complete recovery occurs within 24 hours.2 Removing ticks may not be easy and it is very difficult to remove nymphs without damaging them. It is important to completely remove the tick, including the mouth part and the cement the tick has secreted to secure its attachment.1 A small tick remnant in the skin is difficult to detect and localize, and attempts to remove these parts may result in significant skin trauma or a secondary skin infection. Improper tick removal may lead to infection or granu-loma formation, which must always be surgically resected during a second procedure.
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