Comparison of the diagnostic efficacy of Tzanck smear with histopathology and direct immunofluorescence in immunobullous disorders

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Original Article

Author Details : S Aneesh*, BN Raghavendra, Krishnan Aaryambika, Anjan Kumar Patra, KD Bijina

Volume : 5, Issue : 3, Year : 2019

Article Page : 211-215

https://doi.org/10.18231/j.ijced.2019.045

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Abstract

Introduction: The immunobullous disorders have severe impact on the patients and their family and have
severe economic and health related consequences associated with pain, agony and loss of manpower.
Tzanck smear being a bed side test can aid in establishing the clinical diagnosis with ease and rapidity
and can serve as an adjunct to routine histological study. This study was undertaken to assess the utility
of Tzanck test for early diagnosis of various immunobullous disorders and correlate the findings with
histopathology and direct immunofluorescence.
Objectives: 1.To study Tzanck smear, histopathology, and immunofluorescence patterns in immunobullous
disorders. 2.To evaluate diagnostic efficacy and sensitivity of Tzanck smear findings in comparison to
histopathology and direct immunofluorescence in clinically suspected cases of immunobullous disorders.
Materials and Methods: A total of 38 cases clinically diagnosed immunobullous disorders were appraised
during the study. The patients were subjected to Tzanck smear, skin biopsy for histopathology and direct
immunofluorescence. The specimen was sent in 10% buffered formalin and normal saline for routine
histological analysis and DIF respectively to the department of Pathology. The resulting data was tabulated
and statistically analysed for comparison using sensitivity test.
Conclusion: Tzanck smear served as a simple, rapid and non invasive bedside diagnostic tool, which was
cost effective and yield ed quick results. It can be concluded that in pemphigus group of disorders, Tzanck
smear is 100% sensitive, can yield quick results and can serve as first line of investigation rather than
histopathology and DIF which is expensive and takes time for reporting.
Results: Pemphigus vulgaris was the most common immunobullous disease seen in this study, followed by
bullous pemphigoid. Tzanck smear served as a rapid diagnostic tool and showed 100% sensitivity in all the
pemphigus group of disorders which was compar ed with histopathological findings, which also showed
100% sensitivity whereas DIF was positive in 93.54% of cases.

Keywords: Direct immunofluorescence, Histopathology, Immunobullous disorders, Tzanck smear.

How to cite : Aneesh S , Raghavendra B, Aaryambika K, Patra A K, Bijina K, Comparison of the diagnostic efficacy of Tzanck smear with histopathology and direct immunofluorescence in immunobullous disorders. IP Indian J Clin Exp Dermatol 2019;5(3):211-215

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