The use of chalazion clamps to create adequate sustained pressure for slit skin smear

Abstract

CLINICAL CHALLENGE Demonstration of lepra bacilli on skin slit and scrape smears stained by the Ziehl-Neelsen method is an important diagnostic aid for leprosy, especially in resource-poor settings. The technique involves pinching the fold of skindusually of the earlobedtightly between the thumb and index finger until it blanches, making a 5-mm long and 2-mm deep cut, scraping the base of the cut after turning the blade by 908 to collect (bloodless) fluid, and making a smear followed by staining. Often, the physician’s ability to maintain sufficient mechanical pressure to cause blanching is inadequate and may result in a bloody smear causing discomfort to the patient because of multiple slits.