When do you use Tzanck smear?

The Tzanck smear is mainly used in an acute setting to rapidly detect a herpes infection or to distinguish Stevens- Johnson syndrome / toxic epidermal necrolysis (SJS/TEN) from staphylococcal scalded skin syndrome. However, it can be used to diagnose a variety cutaneous infections and blistering diseases.

What does a Tzanck smear not diagnose?

The Tzanck smear confirms that the lesion is herpetic but cannot differentiate between VZV and other herpesviruses. Further, this test has a limited sensitivity compared with other diagnostic methods, such as polymerase chain reaction (PCR) assay.

How do you do a Tzanck smear?

How is a Tzanck smear prepared?

  1. Using a blunt scalpel blade, gently deroof the lesion.
  2. Scrape the base of the lesion.
  3. Smear the tissue onto a clean microscope slide.
  4. Allow it to dry in the air.
  5. Fix the specimen with preservative.

Can you swab for chickenpox?

The best test for varicella or zoster is VZV PCR. Collect a dry swab from skin lesions or vesicles. VZV serology confirms the diagnosis of varicella by the detection of VZV IgM or by seroconversion of VZV IgG (from Not detected to Detected).

What is a positive tzanck smear?

A positive Tzanck test, showing three multinucleated giant cells (“Tzanck cells”) in center. Purpose. diagnosis of varicella-zoster virus and herpes. In dermatopathology, the Tzanck test, also Tzanck smear, is scraping of an ulcer base to look for Tzanck cells.

Which infection would be detected by testing the swab samples of lesions on a tzanck smear?

The diagnosis of acute herpetic disease of the oropharynx can be confirmed by examination of Giemsa- or Wright-stained smears of scrapings from the base of a fresh lesion (Tzanck test) and by culture of scrapings or swab specimens.

How do I know if I’m immune to chickenpox?

Your GP can do a blood test to check if you’re immune to the chickenpox virus (varicella-zoster virus, or VZV). If you’re not, they may recommend an injection of varicella zoster immune globulin (VZIG). This can make the infection milder and not last as long.

Where are tzanck cells found?

Tzanck cells (acantholytic cells) are found in: Herpes simplex. Varicella and herpes zoster. Pemphigus vulgaris.

What is a PCR test for shingles?

Polymerase chain reaction (PCR) is the most useful test for confirming cases of suspected zoster sine herpete (herpes zoster-type pain that occurs without a rash). PCR can be used to detect VZV DNA rapidly and sensitively, and is now widely available.

Can a blood test detect shingles?

Doctors use two types of tests to diagnose chickenpox or shingles: Antibody: When you’re exposed to varicella zoster, your immune system makes proteins to fight it. Your doctor can look for these proteins, called antibodies, in a sample of your blood.

What kind of test is a Tzanck smear?

In dermatopathology, the Tzanck test, also Tzanck smear, is scraping of an ulcer base to look for Tzanck cells. It is sometimes also called the chickenpox skin test and the herpes skin test. It is a simple, low-cost, and rapid office based test.

What kind of workup is needed for chicken pox?

The workup for chickenpox includes a Tzanck smear, vesicular fluid culture, serologic testing, chest radiography, and histologic examination. A Tzanck smear of vesicular fluid, which can be prepared in an office setting, demonstrates multinucleated giant cells and epithelial cells with eosinophilic intranuclear inclusion bodies.

How is a Tzanck test used in dermatopathology?

Tzanck test. In dermatopathology, the Tzanck test, also Tzanck smear, is scraping of an ulcer base to look for Tzanck cells.

When to use chest radiography for chicken pox?

Chest radiography is indicated for adults who are experiencing pulmonary symptoms of chicken pox. Histologic examination of skin lesions does not differentiate VZV from herpes simplex virus (HSV) infection. Intranuclear eosinophilic inclusion bodies are seen in epithelial cells in both infections.