Tzanck test: Difference between revisions

Latest revision as of 11:34, 18 February 2025

A diagnostic test used in dermatology

Tzanck Test[edit]

The Tzanck test is a diagnostic tool used in dermatology to identify certain skin infections and conditions. It involves the microscopic examination of cells scraped from the base of a vesicular or bullous lesion. The test is named after the French dermatologist Arnault Tzanck, who first described it.

Procedure[edit]

The Tzanck test is performed by scraping the base of a blister or vesicle with a scalpel blade. The collected material is then smeared onto a glass slide, air-dried, and stained with a Giemsa stain or Wright's stain. The stained slide is examined under a microscope for the presence of specific cellular changes.

Diagnostic Uses[edit]

The Tzanck test is primarily used to diagnose:

Herpes simplex virus (HSV) infections: The presence of multinucleated giant cells and acantholytic cells is indicative of HSV infections.
Varicella zoster virus (VZV) infections: Similar to HSV, VZV infections also show multinucleated giant cells.
Pemphigus vulgaris: Acantholytic cells are characteristic of this autoimmune blistering disorder.
Cutaneous leishmaniasis: The test can reveal intracellular and extracellular Leishmania parasites.

Limitations[edit]

While the Tzanck test can provide rapid results, it is not specific for any particular virus or condition. It cannot distinguish between HSV and VZV infections, and further testing, such as polymerase chain reaction (PCR) or viral culture, may be necessary for definitive diagnosis.

Related Pages[edit]

Gallery[edit]

References[edit]

Tzanck test
Acantholytic cell and multinucleated giant cell on a smear taken from a vesicular lesion of herpes simplex infection
Extracellular and intracellular leishmania parasites in a patient with cutaneous leishmaniasis
Acantholytic cells on a smear taken from a patient with pemphigus foliaceus
Tadpole cells on a smear taken from a patient with allergic contact dermatitis
A cluster of basaloid cells on a smear taken from a patient with basal cell carcinoma

@@ Line 1: / Line 1: @@
-'''Treatment-resistant depression''' (TRD) is a term used in clinical psychiatry to describe cases of [[major depressive disorder]] (MDD) that do not respond adequately to appropriate courses of at least two [[antidepressants]].
+{{Short description|A diagnostic test used in dermatology}}
+{{Use dmy dates|date=October 2023}}
-==Definition==
+== Tzanck Test ==
-The term "treatment-resistant depression" is generally applied to patients who fail to respond to at least two different trials of antidepressants from different pharmacologic classes, each used for a sufficient duration and at a therapeutic dose. It is important to rule out pseudo-resistance, which can be caused by factors such as noncompliance, inadequate dosing, and substance abuse.
+The '''Tzanck test''' is a diagnostic tool used in [[dermatology]] to identify certain skin infections and conditions. It involves the microscopic examination of cells scraped from the base of a vesicular or bullous lesion. The test is named after the French dermatologist [[Arnault Tzanck]], who first described it.
-==Epidemiology==
+== Procedure ==
-Treatment-resistant depression is relatively common; estimates suggest that around 30% of patients with MDD could be classified as treatment-resistant. The likelihood of treatment resistance increases with the number of previous depressive episodes.
+The Tzanck test is performed by scraping the base of a blister or vesicle with a scalpel blade. The collected material is then smeared onto a glass slide, air-dried, and stained with a [[Giemsa stain]] or [[Wright's stain]]. The stained slide is examined under a microscope for the presence of specific cellular changes.
-==Treatment==
+== Diagnostic Uses ==
-Treatment options for TRD include switching to a different antidepressant, augmentation with a second medication, and [[psychotherapy]]. More invasive treatments such as [[electroconvulsive therapy]] (ECT) and [[deep brain stimulation]] (DBS) may be considered in severe cases.
+The Tzanck test is primarily used to diagnose:
-==Switching Antidepressants==
+* [[Herpes simplex virus]] (HSV) infections: The presence of multinucleated giant cells and acantholytic cells is indicative of HSV infections.
-If a patient does not respond to an antidepressant, a different antidepressant can be tried. This can involve switching within the same class of drugs or to a different class.
+* [[Varicella zoster virus]] (VZV) infections: Similar to HSV, VZV infections also show multinucleated giant cells.
+* [[Pemphigus vulgaris]]: Acantholytic cells are characteristic of this autoimmune blistering disorder.
+* [[Cutaneous leishmaniasis]]: The test can reveal intracellular and extracellular [[Leishmania]] parasites.
-==Augmentation==
+== Limitations ==
-Augmentation strategies involve the addition of a second drug to an existing antidepressant. The second drug is often from a different pharmacologic class. Commonly used augmenting agents include lithium and atypical antipsychotics.
+While the Tzanck test can provide rapid results, it is not specific for any particular virus or condition. It cannot distinguish between HSV and VZV infections, and further testing, such as [[polymerase chain reaction]] (PCR) or viral culture, may be necessary for definitive diagnosis.
-==Psychotherapy==
+== Related Pages ==
-Psychotherapy, including cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), can be effective in treating TRD, particularly in patients with psychosocial stressors or interpersonal difficulties.
+* [[Herpes simplex]]
+* [[Varicella zoster virus]]
+* [[Pemphigus]]
+* [[Leishmaniasis]]
-==Invasive Treatments==
+== Gallery ==
-In severe cases of TRD where other treatments have failed, more invasive procedures such as ECT or DBS may be considered. These treatments can be effective but also carry risks and are generally reserved for the most severe cases.
+[[File:Tzanck_test.png|thumb|right|A Tzanck test being performed.]]
+[[File:Acantholytic_cell_and_multinucleated_giant_cell_on_a_smear_taken_from_a_vesicular_lesion_of_herpes_simplex_infection.jpg|thumb|right|Acantholytic cell and multinucleated giant cell from a herpes simplex infection.]]
+[[File:Extracellular_and_intracellular_leishmania_parasites_in_a_patient_with_cutaneous_leishmaniasis.jpg|thumb|right|Leishmania parasites in cutaneous leishmaniasis.]]
+[[File:Acantholytic_cells_on_a_smear_taken_from_a_patient_with_pemphigus_foliaceus.jpg|thumb|right|Acantholytic cells from pemphigus foliaceus.]]
+[[File:Tadpole_cells_on_a_smear_taken_from_a_patient_with_allergic_contact_dermatitis.jpg|thumb|right|Tadpole cells from allergic contact dermatitis.]]
+[[File:A_cluster_of_basaloid_cells_on_a_smear_taken_from_a_patient_with_basal_cell_carcinoma.jpg|thumb|right|Basaloid cells from basal cell carcinoma.]]
-==See Also==
+== References ==
-* [[Major depressive disorder]]
+{{Reflist}}
-* [[Antidepressant]]
-* [[Psychotherapy]]
-* [[Electroconvulsive therapy]]
-* [[Deep brain stimulation]]
-[[Category:Psychiatry]]
+[[Category:Dermatology]]
-[[Category:Depression]]
+[[Category:Medical tests]]
-[[Category:Mental health]]
+<gallery>
+File:Tzanck_test.png|Tzanck test
-{{stub}}
+File:Acantholytic_cell_and_multinucleated_giant_cell_on_a_smear_taken_from_a_vesicular_lesion_of_herpes_simplex_infection.jpg|Acantholytic cell and multinucleated giant cell on a smear taken from a vesicular lesion of herpes simplex infection
+File:Extracellular_and_intracellular_leishmania_parasites_in_a_patient_with_cutaneous_leishmaniasis.jpg|Extracellular and intracellular leishmania parasites in a patient with cutaneous leishmaniasis
+File:Acantholytic_cells_on_a_smear_taken_from_a_patient_with_pemphigus_foliaceus.jpg|Acantholytic cells on a smear taken from a patient with pemphigus foliaceus
+File:Tadpole_cells_on_a_smear_taken_from_a_patient_with_allergic_contact_dermatitis.jpg|Tadpole cells on a smear taken from a patient with allergic contact dermatitis
+File:A_cluster_of_basaloid_cells_on_a_smear_taken_from_a_patient_with_basal_cell_carcinoma.jpg|A cluster of basaloid cells on a smear taken from a patient with basal cell carcinoma
+</gallery>