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© 2010 The Authors. doi: 10.2340/00015555-0801 Journal Compilation © 2010 Acta Dermato-Venereologica. ISSN 0001-5555 Sir, Ticks are widely distributed haematophagus ectoparasites and have become one of the most important vectors of human pathogens worldwide. In Europe they transmit more vector-borne diseases to humans than any other agent (1). Not only bacteria, but also viruses, protozoa and neurotoxins, can be transmitted to humans by ticks, causing a wide number of infections, which include tick-borne rickettsiosis, anaplasmosis, relapsing fever, tularemia, tick-borne encephalitis, erlichiosis, borreliosis and tick-borne babesiosis (2). DEBONEL is the acronym for DErmacentor-BOrne Necrosis Erythema and Lymphadenopathy, which was coined in Spain by Oteo et al. (3) as an alternative term to the nomenclature TIBOLA (TIck-BOrne LymphAdenopathy) (4). It shows particular epidemiological, clinical and microbiological characteristics, and is therefore considered as a different entity among the rickettsioses group. Being aware of its main features will probably influence the reporting of a growing number of new cases.

Dermacentor-borne Necrosis Erythema and Lymphadenopathy (DEBONEL): A Case Associated with Rickettsia rioja