Nikolsky's Sign

by Carlo Raj, MD

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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

    1. Pemphigus vulgaris
    2. Lichen planus
    3. Erythema multiforme
    4. Systemic lupus erythematosus
    5. Bullous pemphigoid

    Author of lecture Nikolsky's Sign

     Carlo Raj, MD

    Carlo Raj, MD

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