Question:
Nikolsky's sign is seen in which of the following conditions?
Nikolsky's sign is seen in which of the following conditions?
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Skin slides off with pressure due to loss of epidermal cohesion - seen across many blistering diseases.
Updated On: Jun 24, 2026
- Pemphigus
- Herpes zoster
- Bullous impetigo
- All of the above
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The Correct Option is D
Solution and Explanation
Step 1: Nikolsky's sign is positive when lateral pressure on apparently normal skin causes the superficial epidermis to shear off. It indicates loss of cohesion between epidermal cells (acantholysis or a subgranular split).
Step 2: It is positive in pemphigus (the classic example, due to acantholysis from desmoglein antibodies), in bullous impetigo and staphylococcal scalded skin syndrome (where exfoliative toxin cleaves desmoglein-1), and in toxic epidermal necrolysis and herpetic or varicella infections with widespread blistering.
Step 3: Since pemphigus, bullous impetigo and herpes zoster can all show a positive sign, the correct response covers all of them.
Step 4: Hence the answer is all of the above.
Step 2: It is positive in pemphigus (the classic example, due to acantholysis from desmoglein antibodies), in bullous impetigo and staphylococcal scalded skin syndrome (where exfoliative toxin cleaves desmoglein-1), and in toxic epidermal necrolysis and herpetic or varicella infections with widespread blistering.
Step 3: Since pemphigus, bullous impetigo and herpes zoster can all show a positive sign, the correct response covers all of them.
Step 4: Hence the answer is all of the above.
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