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Searching for the Tzanck smear findings in herpes labialis.
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Tzanck smear characteristic findings herpes simplex labialis multinucleated giant cells
Harrison's Principles of Internal Medicine, Twenty First Edition
Page 1516
GradeResponse
Answer: B. Multinucleated giant cells
Explanation:
The image shows herpes labialis (cold sores) — recurrent vesicular lesions on the lips associated with fever, caused by Herpes Simplex Virus (HSV-1).
The Tzanck smear is the key diagnostic test here:
- An early vesicle is unroofed, its base is scraped, and the material is stained with Giemsa or Wright's stain
- The characteristic finding is multinucleated epithelial giant cells (also called Tzanck cells)
- This finding is positive for both HSV and VZV infections
(Harrison's Principles of Internal Medicine, 21st Ed., p. 1516)
Why the other options are wrong:
| Option | Associated with |
|---|---|
| A. Henderson-Patterson bodies | Molluscum contagiosum (intracytoplasmic inclusions) |
| B. Multinucleated giant cells ✅ | HSV / VZV — correct answer |
| C. Acanthocytes | Pemphigus vulgaris (Tzanck smear shows acantholytic cells, not the same) |
| D. Owl eye appearance | CMV infection (intranuclear inclusions in tissue biopsy) |
Answer: B
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