Residents’ corner May 2012. _CarpeDIEM – Dermatological Indications for Electron Microscopy: Herpesvirus infection

ARTICLE

ejd.2012.1735

Auteur(s) : Emmanuella Guenova¹, Martin Schaller²

¹ Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA

² Department of Dermatology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany

Electron microscopy is indispensable in the rapid diagnosis of viral skin infections caused by Herpes viruses (Varicella zoster, Herpes simplex I or II viruses).

Fluid rich in viral particles from the under surface of the roof of a vesicle is embedded in an electron dense material to provide higher contrast between the virus and the background, a technique referred to as negative staining [1]. A search by electron microscopy is undertaken for the presence of viral envelopes and capsid shells, definitive signs of infection caused by a Herpesvirus (figure 1).

This rapid technique provides in less than 30 minutes information as to whether the clinically suspected skin eruption is indeed herpetic or not. The clinical implication of this approach is especially evident in the possibility of immediate adequate therapeutic management of Herpes zoster manifestation in immunosuppressed individuals.

References

1. Guenova E, Schaller M. CarpeDIEM – Dermatological Indications for Electron Microscopy: Orf infection. Eur J Dermatol 2012; 22(2): 293.