Tzanck test

Tzanck test
A positive Tzanck test, showing three multinucleated giant cells ("Tzanck cells") in center.
Purposediagnosis of varicella-zoster virus and herpes
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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.[1]

Tzanck cells (acantholytic cells) are found in:

Arnault Tzanck did the first cytological examinations in order to diagnose skin diseases.[3] To diagnose pemphigus, he identified acantholytic cells, and to diagnose of herpetic infections he identified multinucleated giant cells and acantholytic cells. He extended his cytologic findings to certain skin tumors as well.

Even though cytological examination can provide rapid and reliable diagnosis for many skin diseases, its use is limited to a few diseases. In endemic regions, Tzanck test is used to diagnose leishmaniasis and leprosy. For other regions, Tzanck test is mainly used to diagnose pemphigus and herpetic infections. Some clinics use biopsies even for herpetic infections.[4] This is because the advantages of this test are not well known, and the main textbooks of dermatopathology do not include dedicated sections for cytology or Tzanck smear.[5] A deep learning model called TzanckNet has been developed to lower the experience barrier needed to use this test.[6]

  1. ^ Durdu M (2019). Cutaneous Cytology and Tzanck Smear Test. Springer International Publishing. ISBN 978-3-030-10721-5.
  2. ^ Folkers E, Oranje AP, Duivenvoorden JN, van der Veen JP, Rijlaarsdam JU, Emsbroek JA (August 1988). "Tzanck smear in diagnosing genital herpes". Genitourinary Medicine. 64 (4): 249–54. doi:10.1136/sti.64.4.249. PMC 1194227. PMID 3169755.
  3. ^ Tzanck A (1947). "Le cyto-diagnostic immédiat en dermatologie". Presse Médicale.
  4. ^ Horn TD (December 2008). "Commentary: heading the wrong way: the disappearing Tzanck smear". Journal of the American Academy of Dermatology. 59 (6): 965–966. doi:10.1016/j.jaad.2008.08.025. ISSN 1097-6787. PMID 18929430.
  5. ^ Kelly B, Shimoni T (2009-06-01). "Reintroducing the Tzanck Smear". American Journal of Clinical Dermatology. 10 (3): 141–152. doi:10.2165/00128071-200910030-00001. ISSN 1179-1888. PMID 19354329. S2CID 23928319.
  6. ^ Noyan MA, Durdu M, Eskiocak AH (2020-10-27). "TzanckNet: A convolutional neural network to identify cells in the cytology of erosive-vesiculobullous diseases". Scientific Reports. 10 (1): 18314. doi:10.1038/s41598-020-75546-z. PMC 7591506. PMID 33110197.