Tzanck Test, Nikolsky Sign, and Bulla Spread Sign
Nikolsky Sign - Pathophysiology and Diagnostic Importance
The Nikolsky sign is an important clinical indicator of epidermal fragility seen in autoimmune and infectious dermatological conditions.
Tzanck Test, Nikolsky Sign, and Bulla Spread Sign
Nikolsky Sign - Pathophysiology and Diagnostic Importance
Nikolsky sign is a clinical dermatological finding indicating epidermal fragility. It is commonly observed in conditions like pemphigus vulgaris, toxic epidermal necrolysis (TEN), and staphylococcal scalded skin syndrome (SSSS).
Pathophysiology
The Nikolsky sign occurs due to the loss of cell-to-cell adhesion among keratinocytes, mediated by autoantibodies attacking desmosomal proteins such as desmoglein-1 and desmoglein-3.
Clinical Significance
- Positive Nikolsky Sign: Gentle pressure on unaffected skin causes detachment of the epidermis.
- Diagnostic Importance: Used to differentiate intraepidermal blistering conditions.
Tzanck Test
A rapid cytological test used for diagnosing viral infections such as herpes simplex virus and varicella-zoster virus.
Bulla Spread Sign
Indicates the lateral extension of a blister with gentle pressure, commonly seen in autoimmune blistering disorders.
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