TZANCK SMEAR: AN ORAL PATHOLOGIST'S PERSPECTIVE

Dr. Purva Prakash Patil* and Dr. Prarthana Prakash Patil

ABSTRACT

Tzanck smear has been widely used for diagnosing various cutaneous dermatoses as it is simple, rapid and reliable technique. There are various diseases which clinically present as oral ulcerations or erosions. Differentiating between these diseases is important as treatment for these may vary greatly. Tzanck smears can be useful in such diseases when diagnosis is unclear. The presence of acantholytic cells on cytology readily diagnose pemphigus group of disorders from other immunological diseases like bullous pemphigoid, oral lichen planus, lichenoid reaction, erythema multiforme and aphthous stomatitis. However to differentiate among pemphigus group of disorders in addition to evaluation of Tzanck smears clinical correlation is a must. Infective diseases like herpes infections, staphylococcal infections, candidiasis, leishmaniasis and molluscum contagiosum show pathognomonic features on cytology which helps in rapid diagnosis and prompt treatment. In oral squamous cell carcinoma clinically presenting as an ulcerated lesion typical cytological features facilitate early diagnosis, thus improving prognosis. So when used along with proper history and clinical examination Tzanck smears can serve as rapid adjunctive diagnostic tool in oral ulcerative and erosive lesions in which diagnosis is obscure.

Keywords: Cytology, Tzanck smear, adjunctive diagnostic tool, acantholytic cells, multinucleated giant cells, Leishman Donovan body.