Skin Scraping/Tzanck Smear

Test indications: Detection and characterization of inflammatory/infectious processes of the skin, especially herpetic infections.

Methodology: Routine cytopathologic evaluation.
Performed: Monday-Friday.
Reported: 1 day.

Specimen required: Direct smear of material collected from a skin lesion, usually a vesicle.

Supplies: Two (or more) clean glass sides fixative (95% ethanol), skin scraping spatula, and Cytology test request form.

Collection procedure:
1. Label the slides with the patient’s first and last name, date of birth and specimen source in pencil on the frosted end and place in a container filled with 95% ethanol so the slides are completely covered.
2. Gently scrape the area of abnormality. If the abnormal lesion is a vesicle, remove the covering and scrape both at the base of the vesicle and around the rim.
3. Remove one of the slides from the fixative. Quickly and evenly smear the collected material on one of the glass slides.
4. Immediately re-immerse the slide in fixative. Repeat the process with the second slide, if necessary, for better diagnostic yield.
5. Repeat the process for additional area if necessary. After collection, leave the slides in the 95% ethanol.
6. Submit the specimen and the completed test request form to the Cytopathology Laboratory.

Transport: Each specimen should be placed in a clearly labeled container that is leak proof. Place specimen inside a biohazard transport bag. Paper requisition(s) that accompany the specimen or slides in fixative should be placed in the outside pocket of the biohazard bag to avoid exposure to any leakage of fixative.

Causes for rejection: Incomplete patient requisitions, unlabeled/incorrectly labeled specimen, frozen specimen, incorrect test ordered for specimen, specimen in incorrect or expired fixative, specimen from unauthorized person.

Unacceptable conditions: Air-dried smears.

Stability: Fixed slides: Indefinitely.

Reference interval: By report.

CPT code: 88160

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