Nikolsky's Sign

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.