Tick-borne illness is an increasingly concerning cause of human infectious disease. Not only do ticks transmit disease, but their bites also may cause impressive local reactions. This report highlights a case of a widespread vesicular eruption secondary to bites by larval Amblyomma americanum sustained by a 58-year-old woman. This case posed a diagnostic challenge because of the unusually large number and wide distribution of bites as well as the subsequent vesicular reaction that ensued. It is necessary for dermatologists in tick-endemic areas to keep tick bites in the differential when evaluating vesicular eruptions. In addition, it is important for dermatologists to be aware of the tick species in their area.
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