Typically the rash occurs in a single, wide stripe either on the left or right side of the body or face. Full text get a printable copy pdf file of the complete article 1. In dermatopathology, the tzanck test, also tzanck smear, is scraping of an ulcer base to look for tzanck cells. Cells are examined under a microscope for signs of infection. When the rash is absent early or late in the disease, or in the case of zoster sine herpete, shingles can be difficult to diagnose. Accuracy and reliability of tzanck test compared to histopathology for. Childrens national medical center, washington, dc 1. Tzanck smear evaluation seattle childrens hospital. Dosis awal amitriptilin adalah 75mg sehari kemudian ditinggikan sampai timbul efek terapeutik, bisa sampai 150300mg sehari. Universitas ui bagian patologi anatomi 1979 penyebab. Tzanck test tsahnk, the examination of fluid from a bullous lesion for tzanck cells altered epithelial cells, rounded and devoid of intercellular attachments. The tzanck smear is reliable, inexpensive, and easy and quick to perform. The tzanck smear test is a simple and cheap test that relies on viewing and. The vesicle should be unroofed or the crust removed, and the base scraped with a scalpel or the edge of a spatula.
Pemeriksaan cairan dari bulla melepuh untuk mencari sel tzanck karakteristik varicella cacar air, herpes zoster, herpes simpleks, dan pemphigus vulgaris. Two to four days before the rash occurs there may be tingling or local pain in the area. Tzanck smear preparat diambil dari discraping dasar vesikel yang masih baru, kemudian diwarnai dengan pewarnaan yaitu hematoxylineosin, giemsas, wrights, toluidine blue ataupun papanicolaous. The tzanck smear is helpful for diagnosing acute infection with a herpes virus, but does not distinguish between hsv and vzv.
Tzanck smear for anogenital lesions suspected of being caused by herpes simplex virus hsv infection, and we compare the results with those of virus culture. Sementara proses ini berlangsung,timbul lagi vesikelvesikel baru sehingga menimbulkan gambaran polimorfi. The tzanck smear is mainly used in an acute setting to rapidly detect a herpes infection. The significance of tzanck smear in evaluation of vesiculo. Obat yang biasa digunakan adalah asklovir dan modifikasinya, misalnya valasiklovir. Otherwise there are typically few symptoms though some may. George papanicolaou is considered the father of exfoliative cytology, but cytology was first used in cutaneous disorders by tzanck in 1947, for the diagnosis of vesiculobullous disorders, particularly herpes simplex. Sel epidermis sel ini mempunyai ukuran 23 kali lebih besar dari pmn. Diagnostic value of tzanck smear in various erosive.
Comparison of tzanck smear, viral culture, and dna diagnostic methods in detection of herpes simplex and varicellazoster infection. A useful diagnostic tool gupta lk, singhi m k indian. Herpes zoster telah dikenal sejak zaman yunani kuno. Routine use of a highly automated and internally controlled realtime pcr assay for the. Perinatal varicella american academy of pediatrics. Penatalaksanaan herpes zooster, varisela dan variola. Some practical applications of tzanck smear in dermatological practice are. Purpose herpesviruses are responsible for several superficial infections. Schwartz division of oral medicine, new jersey dental school, newark, nj, usa. Repeat the process for additional area if necessary. Herpes zoster adalah penyakit setempat yang terjadi terutama pada orang tua yang khas ditandai oleh adanya nyeri radikuler yang unilateral serta adanya erupsi vesikuler yang terbatas pada dermatom yang diinervasi oleh serabut saraf spinal maupun ganglion serabut saraf sensoris dari nervus cranialis.
It is emphasized that using tzanck citology in bullous dermatoses may be extended to the skin lesions of pemphigus foliaceus, endemic in brazil. Ciriciri herpes simplex adalah adanya bintilbintil kecil, bisa satu atau sekumpulan, yang berisi cairan, dan jika pecah bisa. The diagnostic reliability of the tzanck smear was reasonably substantial. Feb 15, 2019 varicellazoster virus vzv is the cause of chickenpox and herpes zoster also called shingles. Apart from the rash, most symptoms can occur also in other conditions. Dengan menggunakan mikroskop cahaya akan dijupai multinucleated giant cells. A study on the effectiveness of tzanck smear to diagnose the. Nov 24, 2019 kaposi varicelliform eruption pdf november 24, 2019 admin medical leave a comment on kaposi varicelliform eruption pdf kaposis varicelliform eruption is a rare and potentially fatal viral infection caused mainly by reactivation of herpes simplex virus. Pdf downloaded from gale expanded academic 28th september 2015. The tzanck smear test is an inexpensive, useful, and an easy diagnostic tool for vesiculobullous lesions of skin diseases and can be. Jun 07, 2017 tzanck smear with methylene blue stain for herpes the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Nov 30, 2016 komplikasi herpes zoster dapat terjadi pada 1015% kasus, komplikasi yang terbanyak adalah neuralgia paska herpetik yaitu berupa rasa nyeri yang persisten setelah krusta terlepas. Komplikasi jarang terjadi pada usia di bawah 40 tahun, tetapi hampir. Tzanck smear definition of tzanck smear by medical dictionary. Meski tidak menyembuhkan infeksi herpes namun dapat menurunkan keparahan penyakit dan nyeri. Diagnostic reliability of the tzanck smear in dermatologic.
The workup for chickenpox includes a tzanck smear, vesicular fluid culture, serologic testing, chest radiography, and histologic examination. Herpes zoster adalah penyakit setempat yang terjadi terutama pada orang tua yang khas ditandai oleh adanya nyeri radikuler yang unilateral serta adanya erupsivesikuler yang terbatas pada dermatom yang diinervasi oleh serabut saraf. Direct cytologic exam positive active infection use wrightgiemsa stain followed by tzanck smearsee multinucleated giant cells. Komplikasi jarang terjadi pada usia di bawah 40 tahun, tetapi hampir kasus terjadi pada usia di atas 60 tahun. For viral infections, samples should be taken from a fresh vesicle, rather than a crusted one, to ensure the yield of a number of virus infected cells. Preparation of tzanck smear tzanck smear is a very simple and rapid technique. Pcr positive active infection detects hsv in tissue, csf, or cell samples. Sering ditemukan pembesaran kelenjar getah bening diseluruh tubuh, dapat pula ditemukan necrosis fokal pada pankreas,hati,paruparu,limfa,saluran pencernaan dan adrenaljarang menyebabkan kematian. Scleroderma adalah penyakit langka kronis yang menyerang pertahanan tubuh. Gejala prodromal yakni demam tidak terlalu tinggi,malese dan nyeri kepala,disusul timbul erupsi kulit berupa papul eritematosa yang dalam beberapa jam berubah menjadi vesikel. Efek sampingnya antara lain gangguan jantung, sedasi, dan hipotensi. Pickering lk, baker cj, kimberlin dw, long ss, eds. A positive tzanck test, showing three multinucleated giant cells tzanck cells in center.
Diagnosis and management of stevensjohnson syndrome. The periphery of these cells is basophilic and the nucleus is spheric and enlarged with prominent nucleoli. There were 8 cases of herpes zoster and tzanck smear w as reported positive in 5 cases 62. A tzanck smear of vesicular fluid, which can be prepared in an office setting, demonstrates multinucleated giant cells and epithelial cells with eosinophilic intranuclear inclusion. Listing a study does not mean it has been evaluated by the u. Pemphigus vulgaris adalah penyakit autoimmune berupa bula bersifat kronik yang dapat mengenai membran mukosa dan kulit dengan karakteristik histopatologis di jumpai adanya akantolisis disebabkan tidak adanya kohesi antara selsel epidermis, sel akantolisis ini dapat dilihat dengan tzanck smear dan dengan pemeriksaan. Dec 14, 2010 posted on december 14, 2010, in kulit kelamin, skills lab and tagged herpes simplex, herpes zoster, metode test tzank, tzank smear, varicella. Tzanck smear definition of tzanck smear by medical. The tzanck smear test is a simple, rapid, valuable, and costeffective diagnostic method based on the investigation of characteristics of individual cells. Skin biopsy with frozen section examination will find intradermal cleavage with acantholysis in the subgranular layer whereas in sjs and ten fullthickness epidermal necrosis and dermalepidermal separation are found. The diagnostic accuracy of the tzanck smear is known, but its diagnostic reliability has. The sensitivity of the tzanck smear exceeds 80% and the specificity 90% when the investigators are experienced.
The value of tzanck smear test in diagnosis of erosive, vesicular, bullous, and pustular skin lesions. The tzanck smear is a useful cytopathologic test in the rapid diagnosis of herpetic lesions, though it cannot differentiate between herpes simplex virus type 1, herpes simplex virus type 2, and varicellazoster virus. Shingles, also known as zoster or herpes zoster, is a viral disease characterized by a painful skin rash with blisters in a localized area. Herpes zoster disebabkan oleh virus yang sama dengan varisela, yaitu virus varisela zoster. Scleroderma adalah pdf scleroderma is a disease affecting the skin and other organs of the body. Jun 04, 2018 nahass gt, goldstein ba, zhu wy, serfling u, penneys ns, leonardi cl. Pengertian pap smear adalah suatu tes yang aman dan murah dan telah dipakai bertahuntahun lamanya untuk mendeteksi kelainankaelainan yang terjadi pada selsel leher rahim fitria, 2007. The tzanck smear although an old tool, still remains a simple, rapid, easily applied, and inexpensive test for these skin lesions. Pemeriksaan ini biasanya digunakan untuk herpes zoster, herpes simplex, dan varicella. Pdf the tzanck smear test is a simple, rapid, valuable, and costeffective diagnostic method based on the investigation of characteristics of. Drug of choicenya adalah acyclovir yang dapat mengintervensi sintesis virus dan replikasinya. For pemphigus vulgaris, out of 4 cases, 2 50% were reported positive on tzanck smear. Komplikasi herpes zoster dapat terjadi pada 1015% kasus, komplikasi yang terbanyak adalah neuralgia paska herpetik yaitu berupa rasa nyeri yang persisten setelah krusta terlepas.
Tzanck preparation definition of tzanck preparation by. A positive tzanck smear is an especially reliable and useful diagnostic aid. Drug of choice nya adalah acyclovir yang dapat mengintervensi sintesis virus dan replikasinya. The tzanck smear is certainly useful and very reliable in the diagnosis of herpes smiplex and varicella. It is sometimes also called the chickenpox skin test and the herpes skin test. Accuracy and reliability of tzanck test compared to histopathology for diagnosis of basal cell carcinoma. A tzanck smear will find acantholytic cells in ssss but not ten.
Dapat diberikan secara oral, topical atau parenteral. Quickly and evenly smear the collected material on one of the glass slides. Pemberian lebih efektif pada hari pertama dan kedua pasca kemunculan vesikel. Tzanck smear with methylene blue stain for herpes full text. Definition tzanck preparation is a rapid test done to diagnose infections caused by herpesviruses. There is still no cure for scleroderma but effective treatments for some forms of the. Cutaneous cytology has long been shown to be useful in the diagnosis of several erosive, vesicular, and bullous skin lesions.
Tzanck smear pada cairan vesikuler menunjukkan adanya giant cell yang multinuklear dan badan inklusi eosinofil intranuklear pada sel epitel isolasi virus vzv dengan melakukan kultur cairan vesikel merupakan diagnosis defenitif, walaupun pembiakan virus vzv merupakan. Kelly b, shimoni t reintroducing the tzanck smear, am j clin dermatology 2009. Vesikel berubah menjadi pustul kemudian menjadi krusta. Tzanck smear with methylene blue stain for herpes full.
This study was designed to determine the ability of practicing dermatologists to interpret tzanck. Deteksi sitologi terhadap perubahan seluler dari infeksi hsv adalah tidak sensitif dan tidak spesifik, baik untuk lesi genital tes tzanck dan pap smear cervical dan sebaiknya tidak digunakan sebagai acuan dalam mendiagnosis infeksi hsv. Diagnosis and management of stevensjohnson syndrome and. Chickenpox follows initial exposure to the virus and is typically a relatively mild, selflimited childhood illness with a characteristic exanthem. Pemeriksaan diagnostik herpes zoster tes diagnostic ini untuk membedakan dari impetigo, kontak dermatitis dan herpes simplex 1. Herpes zoster adalah radang kulit akut dan setempat disebabkan oleh virus, terutama terjadi pada orang tua yang khas ditandai adanya. The tzanck smear is a simple, easily applicable, rapid, and inexpensive test for the diagnosis of erosive vesiculobullous, tumoral, and granulomatous diseases. Tzanck smear with methylene blue stain for herpes the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Obat lain yang dapat digunakan adalah antidepresi trisiklik misalnya nortriptilin dan amitriptilin yang menghilangkan nyeri pada 4467% kasus. Pap smear adalah ilmu yang mempelajari selsel yang lepas dari sistem alat kandungan wanita lestadi, 2009. Dinamakan untuk kulit arnault rusia tzanck 18861954. Geisinger medical laboratories cytopathology specimen. If the abnormality is a vesicle, remove the covering and scrape both at the base of the vesicle and around the rim. Kerokan di fiksasi pada preparat dengan cara dilewatkan di atas api 3x. Biasanya polygonal, inti ditengah, mengandung granula halus dan sering melekat satu dengan yang lainnya membentuk kelompok sel sel achantolytic tzank selsel ini adalah epidermis yang terbentuk bulat dengan pengecatan berwarna gelap. Pdf diagnostic value of tzanck smear in various erosive. Comparison of tzanck smear, viral culture, and dna diagnostic methods in detection of herpes simplex and varicella zoster infection. Pdf the value of tzanck smear test in diagnosis of. A giemsa or wright stain used for morphologic identification of viral cytopathic effects cytopathic effects include the 3 ms. Repeat the process with the second slide, if necessary, for better diagnostic yield.
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