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
Medenica M, Steinberg T. 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
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