Diseases of the skin belong to a separate group - dermatological pathologies. There are a lot of varieties. For the selection of adequate treatment, accurate diagnosis of dermatological diseases is important. One of the first methods is a physical examination. It begins with an examination of the skin and verification of 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 the Nikolsky symptom. In most cases, it occurs in various types of pemphigus.
Symptom of Nikolsky - what is it?
This manifestation of dermatological pathologies has been known since the end of the 19th century. Nikolsky's symptom is often found in pemphigus, but 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 refers to changes in the prickly layer of the epidermis, as a result of which disturbances in the intercellular connections develop. Nikolsky's symptom must be checked both on the skin 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.
What diseases does this symptom occur in?
It should be noted that the Nikolsky symptom with pemphigus is not always found. This disease has several forms. Most of the varieties of pemphigus are accompanied by acantholysis. In this case, a positive version of the Nikolsky symptom is noted. The following types of disease are distinguished:
- Pemphigus vulgaris. This pathology affects mainly women aged 40 to 60 years. In this case, there are violations of the oral mucosa. Bubbles appear on the surface of the gums, tongue, cheeks. After opening, erosion remains.
- Pemphigus vegetative. This type is different in that in addition to the oral cavity, skin areas are affected. Most often it is inguinal folds, armpits, anus, umbilical ring. Bubbles are more superficial and have a smaller shape. The disease is rare.
- Pemphigus foliage. It features a sudden onset and rapid development. Bubbles are localized on the scalp, head. After opening them, thin crusts remain (resemble sheets of skin).
All these types of pemphigus belong to acantholytic forms. Symptom Nikolsky with them is positive. With other varieties of the disease, it is negative.
Diagnosis of Nikolsky's symptom
There are 3 ways in which you can diagnose Nikolsky's symptom with pemphigus (photos of the disease are presented in the article). In the first case, the doctor pulls tweezers on the bladder cap. At the same time, rejection of healthy skin in the form of a tape takes place. The second way is to rub the epidermis between the bubbles. In this case, the skin, which seemed healthy, also begins to be rejected. In the third case, the doctor makes sliding movements in areas far from the blisters. In these places, the epidermis is easily damaged, leaving an erosive surface.