Murat Durdu - Cutaneous Cytology and Tzanck Smear Test

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Many skin diseases with different etiological causes can be clinically confused with each other, and different diagnostic tests are required to distinguish these diseases. An ideal test for diagnosis should be simple, fast, inexpensive, and repeatable. Considering the advantages and disadvantages of diagnostic tests, the best diagnostic method for vesiculobullous erosive lesions and papular, pustular, nodular, and tumoral lesions is cytology. Taking samples for cutaneous cytology is painless, and therefore anesthesia is not necessary. Moreover, multiple samples can be taken from different lesions and regions where taking a biopsy is difficult. The Tzanck test or Tzank smear has some advantages in regard to cutaneous cytology; it is simple, reliable, rapid, repeatable, and inexpensive.

Despite all these advantages, however, the use of the Tzanck test is usually limited to a few diseases in daily dermatology practice. The most important reason for this is that there is no book on cutaneous cytology. Vincenzo Ruocco published an atlas containing the cytological findings of skin diseases in 1980. But his book is not available today. The purpose of this book is to provide a resource for all dermatology assistants, specialists, and academic staff. Hence, this book presents numerous pictures and algorithms to follow for reaching a cytological diagnosis based on key cytological findings.

As the editor of this book, I would like to thank professor Gl Erkin and doctor Serkan Yaar elik for supplying histopathological pictures (Fig ). I also thank my teachers, colleagues, and friends. I greatly appreciate doctor Selen Taner for her help in English grammar. I would also like to thank my family; my wife, Figen, has been extremely supportive of me throughout my academic life.

The first cytological examinations were performed without staining. Direct microscopic examination shows acantholytic cells (arrows) in a patient with herpetic infection (1000)