Tzanck Smear: At Brink of Extinction Part 2

Cytodiagnosis is very easy, rapid and affordable method. Its different techniques include aspiration cytology, imprint smear, exudate smear, skin scrapping smear and Tzanck smear.

Acantholysis, in which the intercellular connections between epithelial cells break down and coherence is lost, is essentially identified by Tzanck smear. The cells become rounder and lose their attachment to one another, yet they stay intact. 

In 1947, it was Frechman Tzanck who diagnosed vesiculobullous diseases using the acantholysis theory. Although, the standard diagnostic methods for cutaneous disorders are histopathology, direct immunoflouresence test and immunologic tests, Tzanck smears can be utilized as diagnostic screening tests. It can be inferred from analyzing Tzanck smear performance in different illnesses that they are effective in ruling out pemphigus. Nevertheless, they cannot take the place of standard histopathology.

Tzanck smear is essentially balancing the beam of pros and cons as it approaches the edge extinction. But it can still be utilized as a glimmer of hope in high workload settings if their effectiveness is thoroughly understood.

References

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3. Grossman and Silvers. The Tzanck smear: Can dermatologists accurately interpret it? J Am Acad Dermatol 1992; 27:403-5.

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5. Patel M, Modi T. Effectiveness of Tzanck smear in various dermatosis-a cytodiagnostic approach. IOSR J Diagn Med Sonogr 2020; 19:4–9.

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8. Pariser RJ. Diagnosis of spongiotic vesicular dermatitis by Tzanck smear: The “tadpole cell”. J Am Acad Dermatol 1983; 8:519‑22.