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The Nikolsky sign is dislodgement of intact superficial epidermis by a shearing force, indicating a plane of cleavage in the skin epidermal-epidermal junctions (e.g., desmosomes). The histological picture involves thinner, weaker attachments of the skin lesion itself to the normal skin – resulting in easier dislodgement.
If no lesions are present on examination it may be useful way of demonstrating reduced epithelial adhesion. In contrast, in Pemphigus, the epithelium tends to disintegrate rather than form a bulla. Nikolsky's sign is present in pemphigus and mucous membrane pemphigoid, but not in bullous pemphigoid.
SSSS is a clinical diagnosis. This is sometimes confirmed by isolation of S. aureus from blood, mucous membranes, or skin biopsy; however, these are often negative. Skin biopsy may show separation of the superficial layer of the epidermis (intraepidermal separation), differentiating SSSS from TEN, wherein the separation occurs at the dermo-epidermal junction (subepidermal separation).
The diagnosis is based on involvement of less than 10% of the skin. [2] It is known as TEN when more than 30% of the skin is involved and an intermediate form with 10 to 30% involvement. [3] A positive Nikolsky's sign is helpful in the diagnosis of SJS and TEN. [9] A skin biopsy is helpful, but not required, to establish a diagnosis of SJS and ...
[2] [3] It is seen along with Nikolsky's sign, both used to assess the severity of some blistering diseases such as pemphigus vulgaris and severe bullous drug reactions. [ 4 ] This sign is named for the Danish physician Gustav Asboe-Hansen (1917–1989), who first described it in 1960.
Diagnosis is based on a skin biopsy and involvement of more than 30% of the skin. [3] TEN is a type of severe cutaneous adverse reactions (SCARs), together with SJS, a SJS/TEN, and drug reaction with eosinophilia and systemic symptoms. [5] It is called SJS when less than 10% of the skin is involved and an intermediate form with 10 to 30% ...
Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. [1] A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan.
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