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It is also associated with pemphigus vulgaris and pemphigus foliaceus. [6] [7] It is useful in differentiating between the diagnosis of pemphigus vulgaris or mucous membrane pemphigoid (where the sign is present) and bullous pemphigoid (where it is absent). The Nikolsky sign is dislodgement of intact superficial epidermis by a shearing force ...
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).
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 TEN. [9]
In 1896, he defended his doctoral thesis on pemphigus foliaceus, in which he described a dermatological condition involving a weakening relationship among the epidermal layers. The sloughing of skin associated with certain varieties of this condition is now referred to as Nikolsky's sign .
The tissue is skin from a patient with Pemphigus vulgaris. Note the intercellular IgG deposits in the epidermis and the early intraepidermal vesicle caused by acantholysis. Pemphigus (/ ˈ p ɛ m f ɪ ɡ ə s / or / p ɛ m ˈ f aɪ ɡ ə s /) is a rare group of blistering autoimmune diseases that affect the skin and mucous membranes. [1]
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