Nikolsky?s sign

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Nikolsky's sign Skin layers

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Nikolsky?s sign

Nikolsky's sign involves the superficial layers of skin slipping free from the lower layers with slight pressure.

A positive Nikolsky's sign is present in the scalded skin syndrome (caused by staphylococcal infection) and in a slightly different form in toxic epidermal necrolysis (a severe drug reaction). It may also be seen in pemphigus vulgaris (a disease which causes blisters to form on the skin).

In each of these diseases, the skin is loosened and when rubbed, slips free just as the skin on a blanched tomato or peach would. The area beneath is pink and moist and may be very tender.

• Scalded skin syndrome (also called Ritter disease)
• Toxic epidermal necrolysis
• Pemphigus vulgaris

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