Noormohammadpour Pedram, Kamyab-Hesari Kambiz, Mousavian Motahare Sadat, Daneshpazhooh Maryam, Balighi Kamran, Ehsani Amir Hooshang, Behjati Mohaddeseh, Tohidi Fatemeh, Amiri Reza
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Dermatol Ther. 2020 Nov;33(6):e13929. doi: 10.1111/dth.13929. Epub 2020 Jul 15.
Rapid diagnosis of pemphigus vulgaris (PV) is an important task in patient's prognosis and treatment. Although PV is routinely diagnosed through investigation of pathology specimens and direct immunofluorescence assays, Tzanck smear can be used as rapid, inexpensive, and easily used test to confirm its clinical diagnosis. This study aimed to determine the diagnostic value of Tzanck smear in erosive oral lesions of PV and also determine its sensitivity and specificity for diagnostic purposes. A total of 68 patients with erosive/ulcerated oral lesions were included in this study and divided into PV (case group) vs other causes of erosive oral lesions (control group). From all participants, two Tzanck smears were prepared for both Giemsa and hematoxylin-eosin (H&E) staining. For definite diagnosis, histopathology and direct immunofluorescence evaluations were performed based on clinical findings. The sensitivity of acantholytic cells in Tzanck smear of erosive oral lesions of PV cases was 80.5% (for both Giemsa and H&E staining), whereas specificity values of Giemsa and H&E staining were 84.6% and 96.3%, respectively. Based on our findings, the Tzanck smear of erosive oral lesions is a simple, quick, and inexpensive test for screening and primary diagnosis of PV.
寻常型天疱疮（PV）的快速诊断对患者的预后和治疗至关重要。尽管PV通常通过病理标本检查和直接免疫荧光检测来诊断，但Tzanck涂片可作为一种快速、廉价且易于使用的检测方法来辅助临床诊断。本研究旨在确定Tzanck涂片在PV糜烂性口腔病变中的诊断价值，并确定其诊断的敏感性和特异性。本研究共纳入68例糜烂性/溃疡性口腔病变患者，分为PV组（病例组）和其他导致糜烂性口腔病变的病因组（对照组）。对所有参与者均制备两张Tzanck涂片，分别进行吉姆萨染色和苏木精-伊红（H&E）染色。根据临床结果进行组织病理学和直接免疫荧光评估以明确诊断。PV病例糜烂性口腔病变Tzanck涂片中棘层松解细胞的敏感性为80.5%（吉姆萨染色和H&E染色均如此），而吉姆萨染色和H&E染色的特异性值分别为84.6%和96.3%。基于我们的研究结果，糜烂性口腔病变的Tzanck涂片是一种用于PV筛查和初步诊断的简单、快速且廉价的检测方法。
