Tzanck smear

Tzanck smear is a microscopic examination of cells taken from the base of a skin lesion. It is named after Arnold Rikli, a Swiss dermatologist who first described the technique in 1947. The test is primarily used to diagnose herpes simplex (HSV), varicella-zoster (VZV), and pemphigus.

Procedure

The Tzanck smear procedure involves scraping the base of a skin lesion with a scalpel blade or glass slide. The collected cells are then smeared onto a glass slide, fixed with alcohol, and stained with Giemsa or Wright's stain. The slide is then examined under a microscope for characteristic cellular changes.

Findings

In a positive Tzanck smear, multinucleated giant cells are seen in cases of HSV and VZV infections. These cells have a characteristic "ground glass" appearance. In pemphigus, acantholytic cells are seen.

Limitations

The Tzanck smear is a quick and inexpensive test, but it has limitations. It cannot differentiate between HSV and VZV, and it may miss infections in their early stages. It also requires a skilled technician to interpret the results. For these reasons, it is often used in conjunction with other diagnostic tests.

See also

• Herpes simplex
• Varicella zoster virus
• Pemphigus vulgaris
• Giemsa stain
• Wright's stain

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