Nikolsky’s sign
Definition
Nikolsky's sign is a skin condition in which the top layers of the skin slip away from the lower layers when slightly rubbed.
Considerations
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 may be 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.
Causes
- Allergic reaction (Toxic epidermal necrolysis)
- Autoimmune condition (Pemphigus vulgaris)
- Bacterial infection ( Scalded skin syndrome)
Home Care
There is no home care for most conditions associated with a positive Nikolsky's sign -- most affected people are hospitalized.
When to Contact a Medical Professional
Call your health care provider if you or your child develop loosening, redness, and blistering of the skin without an obvious cause.
What to Expect at Your Office Visit
The conditions associated with Nikolsky's sign are serious, and most people are sent to the hospital. You will be asked for your medical history and given a physical examination. You may be given fluid and antibiotics through a vein (intravenously).
Your doctor may ask the following questions:
- When did you first notice that the skin was red or blistered?
- What other symptoms occur at the same time?
Reviewed By: Kevin Berman, MD, PhD, Associate, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
