Abstract：
BACKGROUND: Cytological detection of acantholytic keratinocytes (acantholytic cells [AC]) helps to identify canine pemphigus foliaceus (cPF) yet AC also occurs in superficial pyoderma (SP), the main differential diagnosis.
OBJECTIVE: To compare selected cytomorphological features of cPF and SP and to establish cytological diagnostic criteria that could differentiate cPF from SP.
METHODS: 40 and 51 client-owned dogs with PF and SP, respectively.
METHODS: Impression smears from cPF (64), impetigo (40) and exfoliative superficial pyoderma (ESP) (17) samples were stained with Romanowsky stain, randomised, blinded and evaluated by two investigators independently. The entire sample was screened (×500 or ×1000 magnification) for round (AC1), boat (AC2) and raft AC, eosinophils and bacteria. Interobserver agreements were calculated.
RESULTS: The average number of the 10 highest ×500 fields for AC1 and AC2 was significantly higher in PF than SP (p < 0.0001; Kruskal-Wallis test). Rafts and eosinophils were more common in PF than SP (p < 0.0001; chi-square test), while bacteria were rare in PF (5%; p < 0.0001; chi-square test). Observations between the experienced and novice investigators were highly correlated. An ROC analysis identified five AC1/×500-magnification field as a suitable cut-off value for predicting PF diagnosis. This cut-off value was tested by two additional investigators, who identified sensitivity of 84%-100%, specificity of 95%-97% and accuracy of 95%-96% for the diagnosis of cPF.
CONCLUSIONS: Criterion-based impression smear cytological evaluation can provide strong evidence to support the clinical diagnosis. Acantholytic cell morphology varies in cPF and SP, and experience can improve accuracy in cytological differentiation.
OBJECTIVE: To compare selected cytomorphological features of cPF and SP and to establish cytological diagnostic criteria that could differentiate cPF from SP.
METHODS: 40 and 51 client-owned dogs with PF and SP, respectively.
METHODS: Impression smears from cPF (64), impetigo (40) and exfoliative superficial pyoderma (ESP) (17) samples were stained with Romanowsky stain, randomised, blinded and evaluated by two investigators independently. The entire sample was screened (×500 or ×1000 magnification) for round (AC1), boat (AC2) and raft AC, eosinophils and bacteria. Interobserver agreements were calculated.
RESULTS: The average number of the 10 highest ×500 fields for AC1 and AC2 was significantly higher in PF than SP (p < 0.0001; Kruskal-Wallis test). Rafts and eosinophils were more common in PF than SP (p < 0.0001; chi-square test), while bacteria were rare in PF (5%; p < 0.0001; chi-square test). Observations between the experienced and novice investigators were highly correlated. An ROC analysis identified five AC1/×500-magnification field as a suitable cut-off value for predicting PF diagnosis. This cut-off value was tested by two additional investigators, who identified sensitivity of 84%-100%, specificity of 95%-97% and accuracy of 95%-96% for the diagnosis of cPF.
CONCLUSIONS: Criterion-based impression smear cytological evaluation can provide strong evidence to support the clinical diagnosis. Acantholytic cell morphology varies in cPF and SP, and experience can improve accuracy in cytological differentiation.
摘要：
背景：棘皮脱落的角质形成细胞（棘皮脱落细胞[AC]）的细胞学检测有助于识别犬天疱疮（cPF），但AC也发生在浅表脓皮病（SP）中，主要的鉴别诊断。
目的：比较cPF和SP的细胞形态学特征，并建立区分cPF和SP的细胞学诊断标准。
方法：有PF和SP的40和51只客户拥有的狗，分别。
方法：来自cPF（64）的印象涂片，脓疱病（40）和剥脱浅层脓皮病（ESP）（17）样品用罗曼诺夫斯基染色剂染色，随机化，盲化,由两名研究者独立评估.将整个样品筛选(×500或×1000放大)为圆形(AC1),船（AC2）和筏板AC，嗜酸性粒细胞和细菌。计算了观察员之间的协议。
结果：在PF中，AC1和AC2的10个最高×500场的平均数明显高于SP（p<0.0001；Kruskal-Wallis检验）。漂流和嗜酸性粒细胞在PF中比SP中更常见（p<0.0001；卡方检验），而细菌在PF中很少见(5%；p<0.0001；卡方检验)。有经验和新手研究者之间的观察结果高度相关。ROC分析确定了五个AC1/×500放大倍数的视野作为预测PF诊断的合适临界值。这个临界值是由另外两名调查人员测试的，他们确定了84%-100%的敏感度，诊断cPF的特异性为95％-97％，准确性为95％-96％。
结论：基于标准的印模涂片细胞学评价可为临床诊断提供有力依据。cPF和SP的棘皮松解细胞形态不同，经验可以提高细胞学分化的准确性。
目的：比较cPF和SP的细胞形态学特征，并建立区分cPF和SP的细胞学诊断标准。
方法：有PF和SP的40和51只客户拥有的狗，分别。
方法：来自cPF（64）的印象涂片，脓疱病（40）和剥脱浅层脓皮病（ESP）（17）样品用罗曼诺夫斯基染色剂染色，随机化，盲化,由两名研究者独立评估.将整个样品筛选(×500或×1000放大)为圆形(AC1),船（AC2）和筏板AC，嗜酸性粒细胞和细菌。计算了观察员之间的协议。
结果：在PF中，AC1和AC2的10个最高×500场的平均数明显高于SP（p<0.0001；Kruskal-Wallis检验）。漂流和嗜酸性粒细胞在PF中比SP中更常见（p<0.0001；卡方检验），而细菌在PF中很少见(5%；p<0.0001；卡方检验)。有经验和新手研究者之间的观察结果高度相关。ROC分析确定了五个AC1/×500放大倍数的视野作为预测PF诊断的合适临界值。这个临界值是由另外两名调查人员测试的，他们确定了84%-100%的敏感度，诊断cPF的特异性为95％-97％，准确性为95％-96％。
结论：基于标准的印模涂片细胞学评价可为临床诊断提供有力依据。cPF和SP的棘皮松解细胞形态不同，经验可以提高细胞学分化的准确性。
