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April 1977

Demonstration of Herpes Virus by Electron Microscopy in the Crust of a Healing Lesion of Eczema Herpeticum

Arch Dermatol. 1977;113(4):523. doi:10.1001/archderm.1977.01640040131033

To the Editor.—  The diagnosis1,2 of eczema herpeticum can be confirmed or supported by demonstration of multinucleated epithelial giant cells in Tzanck cytological smears prepared from vesicular lesions; by demonstration of herpes simplex virus (HSV) particles by electron microscopy in phosphotungstic acid-stained material obtained from vesicle contents and base scrapings; by demonstration of multinucleated epithelial giant cells with eosinophilic intranuclear inclusions in biopsy specimen sections processed for light microscopy; by demonstration of HSV particles in biopsy specimen sections of vesicular lesions prepared for electron microscopy; by demonstration of direct culture of HSV from the lesions; by demonstration of HSV antigen in biopsy specimen sections by means of fluorescent antibody; or by demonstration of a rise in titer of HSV-specific antibody in the blood.With the exception of the last method, fresh lesions are required for these diagnostic demonstrations since older herpetic lesions often yield negative results. The most frequently

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