Diagnostic Techniques

The easiest diagnostic technique is a skin scraping, illustrated above. First, the lesion is anesthetized with lidocaine (top left). Next, the overlying dry scab is rubbed off with an alcohol gauze pad (top middle). The lesion should have fresh tissue exposed (top right). A scalpel blade is then firmly pressed against the ulcer bed and scraped across the ulcer bed (bottom left). The resulting tissue pulp (bottom middle) is smeared on a slide and allowed to air dry (bottom right). A rapid Giemsa stain is then performed.