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The information contained on this page is provided as general health information and is not intended to substitute as medical advice and direction from your physician or health care provider. Please direct any questions related to your health care provider. In an emergency, call 9-1-1 or go to the nearest emergency center.


Nikolsky sign

Definition

Nikolsky sign is a skin finding in which the top layers of the skin slip away from the lower layers when rubbed.

Considerations

Your health care provider may use a pencil eraser or finger to test for Nikolsky sign. The skin is pulled to the side with a shearing pressure on the surface, or by rotating the eraser back and forth.

If the test result is positive, the very thin top layer of skin will shear off, leaving skin pink and moist, and usually very tender.

A positive result is usually a sign of a blistering skin condition. People with a positive sign have loose skin that slips free from the underlying layers when rubbed.

Causes

The Nikolsky sign can be often found in people with:

When to Contact a Medical Professional

Call your provider if you or your child develops painful loosening, redness, and blistering of the skin, which you do not know the cause of (for example, a skin burn).

What to Expect at Your Office Visit

The conditions associated with Nikolsky sign can be serious. Some people need to be admitted to the hospital. You will be asked about your medical history and given a physical examination. You may be given fluid and antibiotics through a vein (intravenously).

Treatment will depend on the cause of the condition.

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Nikolsky sign

References

Habif TP. Vesicular and bullous diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 16.

Marco CA. Dermatologic presentations. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 110.