Nikolsky's Sign: Causes & Reasons

Possible Causes for Nikolsky's Sign

Nikolsky’s sign Nikolsky`s sign was first described by a Russian dermatologist Pyotr Vasilievich Nikolskiy. [lecturio.com]

Although clinically rare, affected skin displays "Nikolsky's Sign" which means that bullae easily extend into adjacent skin when lateral pressure is placed. [pathwaymedicine.org]

Pressure on normal-looking skin can cause it to blister (Nikolsky sign) in people with Pemphigus Vulgaris. [cidpusa.org]

Pemphigus Vulgaris

Nikolsky’s sign Nikolsky`s sign was first described by a Russian dermatologist Pyotr Vasilievich Nikolskiy. [lecturio.com]

sign. [en.wikipedia.org]

sign Treatment Conservative wound care indications for all patients, to prevent secondary bacterial infection antiseptics anesthetic nebulizers for mucosal lesions potent [step2.medbullets.com]

Pemphigus Vegetans

Nikolsky’s sign Nikolsky`s sign was first described by a Russian dermatologist Pyotr Vasilievich Nikolskiy. [lecturio.com]

sign Treatment Conservative wound care indications for all patients, to prevent secondary bacterial infection antiseptics anesthetic nebulizers for mucosal lesions potent [step2.medbullets.com]

[…] and symptoms Flaccid blisters on face, scalp, upper body, and intertriginous areas Nikolsky sign – applying pressure on blister periphery extends lesion laterally Mucosal [arupconsult.com]

Pemphigus Foliaceus

It is manifested clinically by involvement of healthy-appearing skin that blisters when rubbed (Nikolsky sign). PF usually does not involve mucous membranes. [imagejournals.org]

Nikolsky's sign was positive. [e-ijd.org]

Piotr Nikolsky. Bullous pemphigoid forms blister between the epidermis and dermis which result in a thicker skin and are negative for Nikolsky sign. [symptoma.com]

Toxic Epidermal Necrolysis

sign. [ncbi.nlm.nih.gov]

Nikolsky's sign is positive in perilesional skin. [ncbi.nlm.nih.gov]

She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions with mucosal lesions and positive Nikolsky sign. [ncbi.nlm.nih.gov]

Staphylococcal Scalded Skin Syndrome

[…] acute illness in which the Nikolsky's sign can be easily elicited. [ijpd.in]

The erythema is followed by cleavage of the upper epidermis in a large sheets mainly in the head, neck and the flexures, with formation of bullae (Nikolsky sign). [ncbi.nlm.nih.gov]

In hospital he had sudden onset of high fever and erythema, followed by the formation of flaccid bullae and exfoliation, with a positive Nikolsky sign. [ncbi.nlm.nih.gov]

Bullous Pemphigoid

Placing pressure on the bullae do not lead to their extension into underlying skin, and thus the bullae are negative for "Nikolsky Sign". [pathwaymedicine.org]

The Nikolsky sign, where upper layers of epidermis move laterally with slight pressure or rubbing of skin adjacent to a blister, is negative. [merckmanuals.com]

Skin biopsy and IgG titers Distinguishing Bullous Pemphigoid From Pemphigus Vulgaris Disorder Appearance of Lesion Oral Involvement Itching Nikolsky Sign Prognosis Bullous [merckmanuals.com]

Erythema Multiforme

[…] involvement, + Nikolsky sign) Urticaria (annular lesions) Erythema nodosum Viral exanthems Treatment Supportive care Corticosteroids if severe Treat underlying cause if identified [medbullets.com]

sign (as opposed to SJS/TEN) generally mild burning or itchiness; nontender most commonly involves palms/soles backs of hands and feet extensor aspects of forearms and legs [medbullets.com]

’s sign Febrile Staphylococcal scalded skin syndrome (children) Toxic epidermal necrolysis/SJS (adults) Afebrile Toxic epidermal necrolysis Negative Nikolsky’s sign Febrile [wikem.org]

Brazilian Pemphigus Foliaceus

sign). [medical-dictionary.thefreedictionary.com]

[…] goo sel-va'zhem) [Portuguese, literally “wild fire”], FS An autoimmune disease that causes blistering of the skin of the head, neck or trunk, esp. when the skin is rubbed (Nikolsky's [medical-dictionary.thefreedictionary.com]

Bullous Impetigo

sign Localization Face (most common), especially around the nose and mouth Extremities May be pruritic (especially pustules ) but is rarely painful Regional lymphadenopathy [amboss.com]

sign (sheet-like removal of epidermis with sliding pressure) Highly contagious; may occur in outbreaks ( Antonie Van Leeuwenhoek 2009;95:387, Euro Surveill 2009;14:19372 [pathologyoutlines.com]

The result is erythematous, tender and desquamating areas of skin, usually with a positive Nikolsky’s sign. [cirp.org]

Acquired Epidermolysis Bullosa

Nikolsky's sign and bulla spreading sign were positive. Minimal atrophy and pigmentary disturbances were evident on healing. Milia were absent. [ijdvl.com]

Nikolsky’s sign was positive. In addition, mucosal lesions appeared on the tongue and lips. [omicsonline.org]

The Nikolsky and Asboe-Hansen signs (see above) are positive. The crusted lesions may follow an arcuate pattern. Healing occurs without scarring. [plasticsurgerykey.com]

Epidermolysis Bullosa

sign. [en.wikipedia.org]

RDEB presents with blistering and erosions at birth with positive Nikolsky’s sign (extension of blistering or sloughing of epidermis with application of gentle pressure to [hindawi.com]

Theoretically, the blisters should demonstrate a positive Nikolsky's sign, in which the skin sloughs off from slight rubbing, but this is not always reliable. [en.wikipedia.org]

Pemphigus Erythematosus

Physical Examination On a physical exam, pemphigus vulgaris has flat bullae and a positive Nikolsky's sign. [wikidoc.org]

sign; oral ulcers are commonly an initial presenting symptom Three forms: mucosal dominant, with limited skin involvement; mucocutaneous, which affects both skin and mucosa [arupconsult.com]

They will look for an indicator of the condition called Nikolsky’s sign. [healthline.com]

Mucous Membrane Pemphigoid

sign. [ncbi.nlm.nih.gov]

This is known as a Nikolsky sign. A Nikolsky sign is not always present in patients with mucous membrane pemphigoid. [dentistry.uiowa.edu]

Nikolsky's sign is present in pemphigus and cicatricial pemphigoid, but not in bullous pemphigoid. [en.wikipedia.org]

Extensive Burns

Acquired factor X deficiency is an extremely rare situation. It has shown to be associated with systemic amyloidosis, respiratory mycoplasma infection, factor X inhibitors, antiphospholipid antibodies, vitamin K deficiency/liver disease as well as the use of certain medications (meropenem, valproic acid). The pathogenesis[…] [ncbi.nlm.nih.gov]

Stevens-Johnson Syndrome

Nikolsky sign can be positive. Mucosal surfaces are spared. [visualdx.com]

Nikolsky's sign is positive in perilesional skin. [ncbi.nlm.nih.gov]

Nikolsky sign can be positive. Histology will clearly differentiate AGEP from SJS/TEN. [visualdx.com]

Bullous Lichen Planus

sign ( Clinical Nikolsky's sign ). [4], [6], [10], [15], [17], [22] Microscopic Nikolsky's sign Microscopic Nikolsky's sign is the subclinical counterpart of Nikolsky's sign [jiaomr.in]

The vesicles occurred on both normal skin and the lichenified plaques with a negative Nikolsky sign. [mdedge.com]

Bulla spread sign and Nikolsky's sign were both negative. Mucosae, nails and hair were normal. General and systemic examination did not reveal any abnormality. [ijdvl.com]

Herlitz Disease

Abstract A 32-week-old (gestational age) female infant with epidermolysis bullosa letalis (EBL) (confirmed by light and electron microscopy) had a gastric-outlet obstruction on routine roentgenographic examination. An autopsy showed a fibrous cord connecting the stomach and first part of the duodenum in the area[…] [unboundmedicine.com]

Impetigo Neonatorum

The Nikolsky sign could not be elicited. The infant was afebrile. The remainder of the examination findings were normal. [contemporarypediatrics.com]

Nikolsky's sign: is it 'dry' or is it 'wet'?. Br J Dermatol. 1997; 136 (5): p.762-7. Cole C, Gazewood J. Diagnosis and Treatment of Impetigo. [amboss.com]

The Nikolsky sign could not be elicited. The infant was afebrile. The remainder of the examination findings were normal. Bullous impetigo (BI) was diagnosed. [contemporarypediatrics.com]

Peeling Skin Syndrome

The exam may show that the skin slips off when it is rubbed (positive Nikolsky sign). [medlineplus.gov]

The responsible toxins also cause toxic shock syndrome but skin tenderness and Nikolsky's sign are not classic features. [patient.info]

Other symptoms may include the following: Red, painful areas Blistering Fever Chills Weakness Fluid loss Top layer of skin slips off with rubbing (Nikolsky's sign) In newborns [texaschildrens.org]

Linear IgA Dermatosis

Nikolsky sign was negative. Mucosal examination findings were normal. [jamanetwork.com]

sign Negative, though may be positive when pustules are confluent Positive 8, 27 Pathology Subepidermal blistering with predominantly neutrophilic and eosinophilic dermal [jaoa.org]

It should be continued until there is cessation of new bullae formation and Nikolsky's sign can no longer be elicited. [aafp.org]

Peritoneal Adhesion

Nikolsky's sign can appear on perilesional skin or, in some cases, even on healthy skin. [orpha.net]

They will look for an indicator of the condition called Nikolsky’s sign. [healthline.com]

A positive Nikolsky’s sign is when your skin shears off easily when the surface is wiped sideways with a cotton swab or a finger. [healthline.com]

Hydroa Vacciniforme-Like Lymphoma

The blisters were Nikolsky’s sign, filled with clear yellow-colored fluid. Once the blisters were ruptured, there leaved depressed cicatrix. [ncbi.nlm.nih.gov]

Peeling Skin Syndrome Type 3

The exam may show that the skin slips off when it is rubbed (positive Nikolsky sign). [medlineplus.gov]

The responsible toxins also cause toxic shock syndrome but skin tenderness and Nikolsky's sign are not classic features. [patient.info]

Nikolsky sign is positive (ie gentle strokes result in exfoliation ) Other symptoms may include tender and painful areas around the infection site, weakness, and dehydration [dermnetnz.org]

Benign Familial Pemphigus

They had a peripheral scale, and Nikolsky's sign was positive. The lesions healed without scarring, but residual hyperpigmentation was observed. [jamanetwork.com]

Lesions are positive for Nikolsky’s sign (lateral pressure of unblistered skin at the periphery of active lesions causes the epidermis to shear off) and for Asboe Hansen’s [dermnet.com]

sign may be positive 1/3 of cases are sporadic Healing accompanied by hyperpigmentation, but scarring is rare Longitudinal leukonychia (asymptomatic white longitudinal bands [pathologyoutlines.com]

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome

[…] of Nikolsky, and affectation of the airways. [pesquisa.bvsalud.org]

[…] right and left arms, chest and left hemiabdomen seven days later; after his hospital admittance, the patient evolved with violaceous arches in skin, desquamation, positive sign [pesquisa.bvsalud.org]

The diagnosis and timely treatment is fundamental to reverse the natural evolution of this disease and multidiciplinary treatment ensures a better evolution of signs and symptoms [pesquisa.bvsalud.org]

Bacterial Pyoderma

Nikolsky's sign is not present. 1 These blisters rupture easily, leading to the formation of thin, smooth, honey-colored crusts, similar to a coating film, which, upon scaling [scielo.br]

Nikolsky's sign is present. 3 Fluid loss by evaporation of large areas is associated with increased water loss and dehydration. 19 There is no mucosal involvement. 12 Clearing [scielo.br]

Fibular Dimelia-Diplopodia Syndrome

sign Positive Nikolski's sign/achantolysis Hair and scalp anomalies Abnormal fall of hair Abnormal hair texture/hair dysplasia Brittle hair/distrix/trichorrhexis Coarse/thick [readbag.com]

Telangiectasiae of mucosae Telangiectasiae of the skin Telangiectasic erythema/poikiloderma Vesicles/bullous/exsudative lesions/bullous/cutaneous/mucosal detachment Negative Nikolski's [readbag.com]

Seckel-Like Syndrome Type Buebel

Blistering may be induced by rubbing intact, normal appearing skin adjacent to areas of blistering, a phenomenon known as the Nikolsky sign. [rcseagles.com]

Peeling Skin Syndrome Type 1

Nikolsky’s sign was present. The circumcised area was red, edematous, and exuding yellow pus (Fig 1). [cirp.org]

+ Nikolsky’s sign Flaccid bullae easily rupture leaving red, moist erosions. Desquamation will heal without scarring. Mucous membranes are NOT involved with SSSS. [pedemmorsels.com]

Applying slight pressure with side to side movement of a finger to the skin lesions results in displacement of the epidermis from the dermis (positive Nikolsky's sign). [atsu.edu]