Nikolsky's sign

The epidermal detachment and erosion produced when slight tangential pressure or rubbing is applied to clinically involved or perilesional skin, reflecting loss of epidermal cohesion due to intraepidermal acantholysis or widespread epidermal injury.

Causes

• Autoimmune blistering disorders

  • Pemphigus vulgaris

  • Pemphigus foliaceus

• Severe drug-related and systemic causes

  • Toxic epidermal necrolysis (TEN)

  • Stevens–Johnson syndrome (SJS)

• Other blistering and epidermal disorders

  • Staphylococcal scalded skin syndrome

  • Inherited epidermolysis bullosa variants

• Additional causes

  • Severe cutaneous allergic reactions

  • Extensive epidermal damage from burns or trauma

  • Rare acantholytic dermatoses