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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