Tzanck test Tzanck smear - scraping of an ulcer base to look for Tzanck cells. Simple, fast and inexpensive test used for screening of acantholytic diseases. Routine stain : Geimsa Other stains: PAP, Gram stain Immunoflorescence
Tzanck Smear Viral infections Blistering disorders In suspected tumors
Keratinocytes If the cytological sample is taken from normal skin, most of the cells are anucleated keratinocytes.
In some erosive-vesiculobullous and tumoral diseases, the keratinocyte cytoplasm shrinks, becomes rounded, and turns into acantholytic cells, also called Tzanck cells. • These are round, hyperchromatic nucleated cells o The nucleus/cytoplasm ratio of acantholytic cells favors the nucleus. Tzanck cells
These cells have a perinuclear halo with pale staining around the nucleus.
The cytoplasm in the periphery is stained more darkly basophilic and creates an image called as "mourning edge."
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Acantholytic cells, multinucleated giant cells and intranuclear inclusions HSV
Bullous Pemphigoid
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Cell surface of acantholytic cells is either flat or contains sawtooth-like cytoplasmic protrusions. Abundant inflammatory cells Streptocytes and rosette Epic poetry Lyric poetry Saturn is a gas giant and has several rings PEMPHIGUS