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. Dermatological condition that has a high mortality risk and best treated with immunosuppressants
    2. Immunological disorder that is associated with IgA
    3. Dermatological condition in which acantholysis is absent
    4. Seen only in skin conditions involving the dermo-epidermal junction
    5. Absence of immunoglobulins in an immunofluoresence study
    1. Pemphigus vulgaris
    2. Lichen planus
    3. Erythema mutiforme
    4. Lupus erythematosus
    5. Calciphylaxis

    Author of lecture Nikolsky's Sign

     Carlo Raj, MD

    Carlo Raj, MD

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