“Tzanck Smear To The Rescue: Herpetic Lesion Unmasked In A Misdiagnosed Child”

Rapid diagnosis of Herpes zoster at bed side.

Tertiary eye Hospital, India 

This report describes an presentation of HZO in a 10-year-old immunocompetent male, characterized by vesicular lesions sparing the forehead and confined to the nasal bridge, initially misattributed to an insect bite. Ocular involvement was evident, and diagnosis was confirmed via Tzank smear. Prompt initiation of oral and topical antiviral therapy resulted in complete resolution within one week. This case underscores the diagnostic challenges posed by atypical dermatomal distributions and the critical role of cytological evaluation in pediatric HZO.

the use of a Tzanck smear provided rapid cytological confirmation, effectively ruling out other potential causes of vesicular lesions. Importantly, the Tzanck smear not only added diagnostic value but also helped alleviate parental anxiety by providing a rapid diagnosis at the bedside. This case highlights the practical utility of Tzanck smear as a simple, cost-effective, and reassuring tool in the evaluation of pediatric vesicular eruptions suggestive of HZO.