Carefully done Tzanck smears may be positive in crusted herpetic lesions. Tzanck smears and immunofluorescent tests have approximately the same degree of sensitivity and specificity in vesicular lesions but crusts are difficult to prepare for immunofluorescent studies. Some clinicians prefer immunofluorescent stains using monoclonal antibodies to Tzanck smears because smears require more experience for interpretation and immunofluorescent stains can distinguish between herpes 1 and herpes 2. The development of antiviral drugs will progress more rapidly in the future from discovery to use in humans, especially drugs for patients with acquired immunodeficiency syndrome. At present we have reached a plateau for the treatment of herpetic infections with no stunning new drugs in evidence. Therapeutic advances are expected to appear from several possible avenues of investigation.
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