Nikolsky's Sign in Toxic Epidermal Necrolysis (TEN)

Nikolsky's sign is a clinical dermatological sign which is present when slight rubbing of the skin results in exfoliation of the outermost layer.

Nikolsky's sign is almost always present in Stevens-Johnson Syndrome/toxic epidermal necrolysis and Staphylococcal scalded skin syndrome, caused by the exfoliative toxin of Staphylococcus aureus.  It is also associated with pemphigus vulgaris and pemphigus foliaceus. 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). 

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Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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