What is the best test to detect herpes in skin lesions?
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Polymerase chain reaction (PCR) techniques appear to be more sensitive and specific in detecting herpes simplex virus (HSV) in genital lesions (strength of recommendation [SOR]: A, based on 2 diagnostic cohort studies); however, viral culture remains the gold standard (SOR: C, based on expert opinion). Studies of serologic and antibody detection tests report higher sensitivities than viral culture (SOR: C, based on consensus guidelines). Cytologic tests such as the Tzanck smear and Papanicolaou (Pap) smear have poor sensitivities and specificities and should not be relied upon for a diagnosis of genital herpes (SOR: C, based on expert opinion).
Journal of Family Practice, 55(4) 2006: 346+.