What does the positive symptom of Nikolsky mean?

Diseases of the skin are a separate group - dermatological pathologies. There are a lot of varieties of them. For the selection of adequate treatment is important accurate diagnosis of dermatological diseases. One of the first methods is a physical examination. It begins with examining the skin and checking for characteristic symptoms. According to these data, it is possible to distinguish similar diseases from each other. One of the frequent manifestations of dermatological pathologies is a symptom of Nikolsky. In most cases, it occurs with various types of pemphigus.

Nikolsky's symptom - what is it?

This manifestation of dermatological pathologies is known since the end of the 19th century. The symptom of Nikolsky is often found in pemphigus, but it can also occur in other diseases. It consists in the detachment of the skin under the influence of friction. This is due to the process of acantholysis. This medical term implies changes in the prickly layer of the epidermis, as a result of which violations of intercellular connections develop. The symptom of Nikolsky should be checked both on the skin integuments and on the mucous membranes. Often it can be found in the oral cavity. This is due to the fact that some types of pemphigus begin to develop from the gums and the inner surface of the lips.

At what diseases does this symptom occur?

It should be noted that the symptom of Nikolsky with pemphigus is not always met. This disease has several forms. Most of the varieties of pemphigus are accompanied by acantholysis. In this case, a positive variant of Nikolsky's symptom is noted. Distinguish the following types of disease:

1. Vulgar pemphigus. This pathology affects mainly women aged 40 to 60 years. In this case, there are violations of the mucous membrane of the oral cavity. Bubbles appear on the surface of the gums, tongue, and cheeks. After their opening, there are erosions.
2. Pemphigus is vegetative. This species differs in that, in addition to the oral cavity, skin areas are affected. Most often these are inguinal folds, armpits, anus, umbilical ring. Bubbles are more superficial and have a smaller shape. The disease is rare.
3. Pulmonate pemphigus. It is characterized by a sudden onset and rapid development. Bubbles are localized on the hairy areas of the body, the head. After their opening, thin crusts remain (resemble skin sheets).

All these types of pemphigus are acantholytic forms. The symptom of Nikolsky is positive. With other types of disease, it is negative.

Diagnosis of Nikolsky's symptom

There are 3 ways in which it is possible to diagnose Nikolsky's symptom with pemphigus (photo of an ailment presented in the article). In the first case, the doctor pulls the forceps with the tweezers of the bladder. In this case, rejection of healthy skin in the form of tape. The second way is to rub the epidermis between the blisters. At the same time, the skin, which seemed healthy, also begins to be rejected. In the third case, the doctor makes sliding movements in areas far from bubbles. In these places, the epidermis is easily damaged, leaving an erosive surface.