|Basal Cell Carcinoma
|Squamous Cell Carcinoma
|Mycosis Fungoides (Sezary Syndrome)
|Pityriasis/Tinea versicolor infections
|Toxic Epidermal Necrolysis
|Atopic Eczema/Atopic Dermatitis
With touch or pressure, skin will easily exfoliate
What is Nikolsky's sign
- Nikolsky's sign is ability to manually spread a blister by putting force with help of fingers on specific area of skin from side of lesion.
- It is thought that it occurs due to malfunctioning of interacellular adhesion.
- It was presumed to be associated with pemphigus but there are a number of causes.
- The core pathophysiology behind this sign is acantholysis. “Acantholysis” term was described by Auspitz in 1881
- It is defined as the loss of coherence between epidermal cells because of the breakdown of their intercellular bridges.
- Pemphigus: Circulating autoantibodies against Dsg3 (Desmoglein 3) or Dsg1 (Desmoglein 1) results in loss of adhesion between the keratinocytes and furthermore in blister formation
- Staphylococcal scalded-skin syndrome (SSSS) : Staphylococcus aureus which specifically cleaves Desmoglein 1 (Dsg1) in the zona glomerulosa of epidermis
- Toxic epidermal necrolysis: sulphonylureas, sulphonamides, NSAIDs, allopurinol, anti-retroviral therapy, etc., There is immense apoptosis of epidermal cells.
- Lyell's disease
False Nikolksy sign
It is elicited by pulling the peripheral remnant roof of a ruptured blister, thus extending the erosion on the surrounding normal skin.
- Bullous pemphigoid
- Epidermolysis bullosa
- Cicatricial pemphigoid
- Dermatitis herpetiformis
- Bullous systemic lupus erythematosus (SLE).