Nikolsky’s sign

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Nikolsky's sign

Skin layers

Nikolsky's sign is a skin finding in which the top layers of the skin slip away from the lower layers when slightly rubbed.

Nikolsky's sign is either positive or negative. A positive result may be present in several different medical conditions. People with a positive sign have loose skin that slips free from the underlying layers when rubbed. The area beneath is pink and moist and usually very tender.

Typically, your health care provider will test for this sign simply by twisting a pencil eraser against your skin. If positive, a blister will form in the area, usually within minutes.

• Autoimmune condition (Pemphigus vulgaris)
• Bacterial infection ( Scalded skin syndrome)
• Toxic drug reaction (Toxic epidermal necrolysis)

Review Date: 03/11/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Roy Colven, MD, Dermatologist, Associate Professor of Medicine, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).

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