Nikolsky sign positive is a dermatological sign in which gentle lateral pressure on the skin results in the separation of the epidermis from the underlying dermis. It is commonly seen in certain skin conditions, such as pemphigus vulgaris, staphylococcal scalded skin syndrome, toxic epidermal necrolysis, and some forms of bullous pemphigoid. A positive Nikolsky sign indicates increased fragility of the skin and indicates the presence of a blistering disease associated with severe damage to the epidermis and potentially life-threatening consequences. Clinical examination and biopsy evaluation are necessary to confirm the diagnosis of Nikolsky sign positive. Early and appropriate management is critical to prevent morbidity and mortality associated with systemic complications.
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