Comparison of Tzanck smear with viral serology in varicella
Keywords:
Varicella, Tzanck smear, viral serologyAbstract
Objective To compare Tzanck smear with viral serology in terms of concurrence of results in patients with varicella. Methods It was a descriptive case-series done at Dermatology Department, Military Hospital, Rawalpindi. We studied 50 patients of the varicella infection in 6 months. Tzanck smear was taken from each patient at presentation and stained by Giemsa stain for giant cells and evaluated by histopathologist. Viral serology was done by complement fixation method at Virology Department. The results were statistically analyzed with SPSS 16. Results Out of 50 patients of varicella 39 (78%) were males while 11 (22%) were females. Mean age was 30.52 ± 9.763 years. Tzanck smear was positive in 33 (66%) and viral serology in 45 (90%) patients. The concurrence of results in both Tzanck smear and viral serology was seen in 31 patients (62%). Conclusion Tzanck smear is a quick and valuable tool in the diagnosis of patients suffering from varicella.References
Shrerifi Z, Ghanjin SE. The Seroepidemiology of varicella-zoster virus. Allergy Asthma Immunol. 2005;4;95-8.
Raza N, Tariq WZ, Zaidi SK. Onset of adult varicella in relation to rural or urban origin and its complications. J Coll Physicians Surg Pak. 2008;18;95-7.
Nikkels AF, Pierard GE. The Tzanck smear: Heading the right way. J Am Acad Dermatol. 2009;61;152-3.
Senol M, Saglam H, Seyhan M, Durmaz R, Aktas E, Ozerol IH. Comparison of the Tzanck test and polymerase chain reaction in the diagnosis of cutaneous herpes simplex and varicella virus infections. Int J Dermatol. 2007:46:1177-9.
Gupta LK, Singhi MK. Tzanck smear: a useful diagnostic tool. Indian J Dermatol Venereol Leprol. 2005;71:295-9.
Prabhu S, Sripathi H, Gupta S, Prabhu M. Childhood herpes zoster: A clustering of ten cases. Indian J Dermatol. 2009:54:62-4.
Kelly B, Shimoni T. Reintroducing the Tzanck smear. Am J Clin Dermatol. 2009;10:141-5.
Durdu M, Baba M, Seckin D. The value of Tzanck smear test in diagnosis of erosive, vesicular, bullous, and pustular skin lesions. J Am Acad Dermatol. 2008;59:958-64.
Folkers E, Vreeswjk J, Oranje AP, Wagenaar F, Duivenvoorden JN. Improved detection of HSV by electron microscopy in clinical specimens using ultracentrifugation and colloidal gold immune electron microscopy: comparison with viral culture and cytodiagnosis. J Virol Methods. 1991;34:273-89.
Folkers E, Vreeswijk J, Wagenaar F, Kapsenberg JG, Hulsebosch HJ, Oranje AP. Immunoelectron microscopy for rapid diagnosis of varicella-zoster virus in a complicated case of human T-cell lymphotropic virus type 1 infection. J Clin Microbiol. 1992;30:2487-91.
Oranje AP, Folkers E, Choufoer-Habova J, Duivenvoorden JN. Diagnostic value of Tzanck smear in herpetic and non-herpetic vesicular and bullous skin disorders in pediatric practice. Acta Derm Venereol (Stockh). 1986;66:127-33.
Solomon AR, Rasmussen JE, Varani J, Pierson CL. The Tzanck smear in the diagnosis of cutaneous herpes simplex. JAMA. 1984;251:633-5.
Motyl MR, Bottone EJ, Janda JM. Diagnosis of herpes virus infections: correlation of Tzanck preparations with viral isolation. Diagn Microbiol Infect Dis. 1984;2:157-60.
Sadick NS, Swenson PD, Kaufman RL, Kaplan MH. Comparison of detection of varicella-zoster virus by the Tzanck smear, direct immunofluorescence with a monoclonal antibody, and virus isolation. J Am Acad Dermatol. 1987;17:64-9.
Schirm J, Meulenberg JJM, Pastoor GW, van Voorst Vader PC, Schroder FP. Rapid detection of varicella-zoster virus in clinical specimens using monoclonal antibodies on shell vials and smears. J Med Virol. 1989;28:1-6.