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Slides Dermatology Inflammatory Skin Diseases V3.pdf
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00:02 Quickly, what does Nikolsky sign mean? The risk or tendency of the keratinocytes to separate. 00:08 That’s it. 00:10 If it’s positive, is that a good thing or bad thing? When is the last time you want to scrape your skin and it comes right off? It’s a bad thing. 00:18 So now, you tell me, which one was the vulgar disease? Pemphigus vulgaris. 00:22 That’s the one in which it would then be positive Nikolsky sign. 00:26 What do we call this medically? What if you don’t see the term Nikolsky? Then you’ll hear the term achantolysis. 00:33 Allow the name to speak to you. 00:34 Lysis of your keratinocyte. 00:36 Clear? Pressure is placed on the blister or the skin at question. 00:43 If the blister spreads laterally, then Nikolsky sign, obviously, is positive. 00:48 If it doesn’t, then it’s negative. 00:50 If it is positive, then you know it’s pemphigus vulgaris. 00:52 If it’s negative, then high in your differential is bullous pemphigoid, and make sure that you take a full history of your patient.
About the Lecture
The lecture Nikolsky's Sign by Carlo Raj, MD is from the course Inflammatory Skin Diseases.
Included Quiz Questions
A 67-year-old male presents with multiple fragile bullae and blisters on the bilateral lower extremities that sloughs off when you apply pressure during your examination. Which of the following best fits your diagnosis?
- Dermatological condition that has a high mortality risk and best treated with immunosuppressants
- Immunological disorder that is associated with IgA
- Dermatological condition in which acantholysis is absent
- Seen only in skin conditions involving the dermo-epidermal junction
- Absence of immunoglobulins in an immunofluoresence study
A positive Nikolsky sign is a diagnostic feature of which of the following?
- Pemphigus vulgaris
- Lichen planus
- Erythema mutiforme
- Lupus erythematosus
- Calciphylaxis
Author of lecture Nikolsky's Sign
Carlo Raj, MD
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