The study of vesicobullous skin lesions by Tzanck smear cytology

Vesicobullous lesion of skin and mucosa is commonly seen in clinical practice of dermatology. Tzanck smear preparation is simple sensitive, rapid and inexpensive procedure that has capacity to reveal the cytomorphological details associated with various such lesions. This study was conducted to assess Tzanck smear cytology for cytomorphological features and diagnosis in various vesicobullous lesion and correlate the findings with subsequent skin biopsy. The study comprised of 104 patients who underwent Tzanck smear cytology in evaluation of vesicobullous lesion. Tzanck smear preparation of two cases was suboptimal for cellularity and therefore not included in the study. The commonest cytodiagosis was Herpes zoster followed by Pemphigus vulgaris and bullous pemphigoid. 18 cases were reported as inflammatory bullous lesion as they lack evidence of viral infection and also lack the presence of acantholytic cells. Out of 102 cases, 30 cases were biopsied and therefore available for diagnosis. 29 cases correlated with histopathological diagnosis. In the group of 18 cases of non-specific inflammatory bullous lesion a single case underwent biopsy in which a histodiagnosis rendered was bullous pemphigoid. The observation in this group suggested for diligent microscopy, nonrepresentation of cells and possible under interpretation of the lesion. Based on observations made in present study it can be concluded that Tzanck smear is safe, painless, inexpensive and rapid diagnostic test that can be used as first line diagnostic tool in various vessicobullous-ulcerative mucocutaneous lesion.