Nikolsky Sign
Pronunciation: nih-KOL-skee
A clinical test result in which lateral pressure on apparently normal skin causes the epidermis to shear away, indicating intraepidermal blistering disorders.
Full Definition
The Nikolsky sign is elicited by applying tangential mechanical pressure to perilesional or normal-appearing skin; a positive result sees the outer epidermal layers slide or detach, revealing a moist base. It is a key clinical marker used to differentiate bullous disorders: it is positive in pemphigus vulgaris and toxic epidermal necrolysis but typically negative in bullous pemphigoid. In editorial contexts, the sign should be capitalised and written as 'Nikolsky sign' (not 'Nikolsky's sign' in most current style guides). It is a bedside test result documented in both inpatient notes and case reports.
Usage
Usage note: Current dermatological style omits the possessive apostrophe-s: 'Nikolsky sign', not 'Nikolsky's sign'. Flag possessive forms in manuscripts for author query.
In Context
- "A positive Nikolsky sign was recorded across the trunk, prompting urgent dermatology review." — Inpatient clinical notes
- "The case report confirmed a positive Nikolsky sign, consistent with the diagnosis of pemphigus foliaceus." — Peer-reviewed case report