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25-14: Tzanck Preparation for Herpes Infection

Camiron L. Pfennig; B. Ethan Brown

Uses

To detect the multinucleated giant cells confirming the presence of a herpes infection.

Materials

Microscope, Bunsen burner, glass microscope slide, 5% methylene blue or Wright stain or Giemsa stain, immersion oil, and sterile scalpel or hypodermic needle.

Method

  1. Unroof a fresh, uncrusted vesicle with a sterile hypodermic needle or scalpel.

  2. Scrape the floor of the vesicle with the scalpel and smear scrapings of the lesion onto a glass microscope slide.

  3. Let air dry.

  4. Fix specimen with absolute alcohol or gentle heat.

  5. Stain with blue stain (5% methylene blue, Wright stain, or Giemsa stain) for 5 seconds, rinse, and air dry.

  6. View preparation through immersion oil at high power (×40-50).

FIGURE 25.34

Tzanck Preparation. A Tzanck preparation of both the roof and floor of a herpetic vesicle demonstrating a multinucleated giant cell. (Photo contributor: Department of Dermatology, Wilford Hall USAF Medical Center and Brook Army Medical Center, San Antonio, TX.)

A slide under the microscope shows a large dark blue cell with multiple nuclei surrounded by other small, blue cells, on a light blue background.
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