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Paper II — 2022 February (2019 Scheme) — Q9

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Paper II
2022 February (2019 Scheme) · 100 marks · 180 min

Question

Tzanck smear.

Q94 marksShort Answers

Answer

Tzanck smear: a rapid, simple cytological test used to support the diagnosis of herpesvirus infections (Herpes simplex virus, Varicella-zoster virus) and certain other vesiculobullous conditions.

Procedure: the base/floor of a fresh, intact vesicle is scraped/unroofed, and the scraping is smeared onto a glass slide, air-dried, and stained (classically with Giemsa stain, though Wright’s or other stains may also be used).

Findings: demonstration of characteristic multinucleated giant cells with acantholytic (ballooning) degeneration of epidermal cells, and, characteristically, intranuclear (Cowdry type A) inclusion bodies within the multinucleated cells — findings consistent with herpesvirus infection (either HSV or VZV; the test cannot itself distinguish between the two).

Utility/limitations: rapid, inexpensive, bedside-performable test providing supportive evidence of a herpesvirus aetiology; however, it is not specific (cannot distinguish HSV from VZV, and cannot type HSV-1 vs HSV-2), and has largely been supplemented/superseded by more specific and sensitive confirmatory methods such as PCR and direct fluorescent antibody testing, though it remains a useful, rapid adjunct in resource-limited settings.

  1. 1General Properties of Viruses and Virus Host Interaction

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