Which is the first step in a Tzanck preparation?

The first step in a Tzanck preparation involves making an imprint of the affected lesion. This technique is essential for collecting cells from the lesion, particularly in cases of vesicular lesions associated with herpes simplex virus or varicella-zoster virus infections. During this process, a clean, unclean, or even a ruptured lesion can be used to obtain a sample, as the goal is to capture the cellular material for microscopic examination.

Making an imprint allows for rapid access to the epidermal cells that are characteristic of certain viral infections, enabling the diagnosis to be made promptly. In a clinical setting, this step is crucial because it directly influences the quality and validity of the sample that will be evaluated under the microscope. Thus, performing an imprint efficiently sets the stage for subsequent steps in the diagnostic process, such as staining and observation of cell characteristics.