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Nikolsky Sign
Nikolsky's sign is a clinical dermatological sign, named after Pyotr Nikolsky (1858–1940), a Russian physician who trained and worked in the Russian Empire. The sign is present when slight rubbing of the skin results in exfoliation of the outermost layer. A typical test would be to place the eraser of a pencil on the roof of a lesion and spin the pencil in a rolling motion between the thumb and forefinger. If the lesion is opened (i.e., skin sloughed off), then the Nikolsky's sign is present/positive. Nikolsky's sign is almost always present in Stevens–Johnson syndrome/ toxic epidermal necrolysis and staphylococcal scalded skin syndrome, caused by the exfoliative toxin of '' Staphylococcus aureus''. It is also associated with pemphigus vulgaris and pemphigus foliaceus. It is useful in differentiating between the diagnosis of pemphigus vulgaris or mucous membrane pemphigoid (where the sign is present) and bullous pemphigoid (where it is absent). The Nikolsky sign is ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Dermatology
Dermatology is the branch of medicine dealing with the Human skin, skin.''Random House Webster's Unabridged Dictionary.'' Random House, Inc. 2001. Page 537. . It is a speciality with both medical and surgical aspects. A List of dermatologists, dermatologist is a specialist medical doctor who manages diseases related to skin. Etymology Attested in English in 1819, the word "dermatology" derives from the Ancient Greek, Greek δέρματος (''dermatos''), genitive of δέρμα (''derma''), "skin" (itself from δέρω ''dero'', "to flay") and -λογία ''wikt:-logia, -logia''. Neo-Latin ''dermatologia'' was coined in 1630, an anatomical term with various French and German uses attested from the 1730s. History In 1708, the first great school of dermatology became a reality at the famous Hôpital Saint-Louis in Paris, and the first textbooks (Willan's, 1798–1808) and atlases (Jean-Louis-Marc Alibert, Alibert's, 1806–1816) appeared in print around the same time.Freedber ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medical Sign
Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pains in the body, which occur as the body's immune system fights off an infection. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or medical condition that may be detected during a physical examination. These signs may be visible, such as a rash or bruise, or otherwise detectable such as by using a stethoscope or taking blood pressure. Medical signs, along with symptoms, help in forming a diagnosis. Some examples of signs are nail clubbing of either the fingernails o ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pyotr Nikolsky
Pyotr Vasilyevich Nikolsky (; September 13 [ O.S. September 1] 1858 – March 13, 1940) was an Imperial Russian and later Soviet dermatologist. He was born in Usman, Tambov Governorate, Russian Empire and earned his medical degree from the Saint Vladimir Imperial University of Kyiv in 1884. After graduating, he studied under Mikhail Stukovenkov at the Department of Dermatology and Venerology in Kyiv. In 1896, he defended his doctoral thesis on pemphigus foliaceus, in which he described a dermatological condition involving a weakening relationship among the epidermal layers. The sloughing of skin associated with certain varieties of this condition is now referred to as Nikolsky's sign. In 1898, he became a professor at the Imperial University of Warsaw, and later established the Department of Dermatology and Venerology in Rostov at what is now Rostov State Medical University. He published articles in French as well as Russian on skin diseases and on the treatmen ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Desquamation
Desquamation, or peeling skin, is the shedding of dead cells from the outermost layer of skin. The term is . Physiologic desquamation Keratinocytes are the predominant cells of the epidermis, the outermost layer of the skin. Living keratinocytes reside in the basal, spinous, or granular layers of the epidermis. The outermost layer of the epidermis is called the stratum corneum and it is composed of terminally differentiated keratinocytes called the corneocytes. In the absence of disease, desquamation occurs when corneocytes are individually shed unnoticeably from the surface of the skin. Typically the time it takes for a corneocyte to be formed and then shed is about 14 weeks but this time can vary depending on the anatomical location that the skin is covering. For example, desquamation occurs more slowly at acral (palm and sole) surfaces and more rapidly where the skin is thin, such as the eyelids. Normal desquamation can be visualized by immersing skin in warm or hot water ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Stevens–Johnson Syndrome
Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. Together with toxic epidermal necrolysis (TEN) and #Classification, Stevens–Johnson/toxic epidermal necrolysis (SJS/TEN) overlap, they are considered febrile mucocutaneous drug reactions and probably part of the same spectrum of disease, with SJS being less severe. Erythema multiforme (EM) is generally considered a separate condition. Early symptoms of SJS include fever and flu-like symptoms. A few days later, the skin begins to blister and peel, forming painful raw areas. Mucous membranes, such as the mouth, are also typically involved. Complications include dehydration, sepsis, pneumonia and multiple organ failure. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulfonamide antibiotics and nevirapine. Other causes can include infections such as ''Mycoplasma pneumoniae'' and cytomegalovirus, or the cause may remain unknown. Risk factors include HIV/AIDS and syste ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Toxic Epidermal Necrolysis
Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a type of severe skin reaction. Together with Stevens–Johnson syndrome (SJS) it forms a spectrum of disease, with TEN being more severe. Early symptoms include fever and flu-like symptoms. A few days later the skin begins to blister and peel forming painful raw areas. Mucous membranes, such as the mouth, are also typically involved. Complications include dehydration, sepsis, pneumonia, and multiple organ failure. The most common cause is certain medications such as lamotrigine, carbamazepine, allopurinol, sulfonamide antibiotics, and nevirapine. Other causes can include infections such as '' Mycoplasma pneumoniae'' and cytomegalovirus or the cause may remain unknown. Risk factors include HIV/AIDS and systemic lupus erythematosus. Diagnosis is based on a skin biopsy and involvement of more than 30% of the skin. TEN is a type of severe cutaneous adverse reactions (SCARs), together with SJS, a SJS ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Staphylococcal Scalded Skin Syndrome
Staphylococcal scalded skin syndrome (SSSS) is a dermatology, dermatological condition caused by ''Staphylococcus aureus''. Signs and symptoms The disease presents with the widespread formation of fluid-filled blisters that are thin walled and easily ruptured, and the patient can be positive for Nikolsky's sign. SSSS bears a resemblance to thermal burns or scalding, hence the condition's name. Ritter's disease of the newborn is the most severe form of SSSS, with similar signs and symptoms. SSSS often includes a widespread painful erythroderma, often involving the face, diaper, and other intertriginous areas. Extensive areas of desquamation might be present. Perioral crusting and fissuring are seen early in the course. Unlike toxic epidermal necrolysis, SSSS spares the mucous membranes. Children with SSSS may exhibit fussiness or irritability, tiredness, fever, redness of the skin, easily broken fluid-filled blisters that leave an area of moist, tender, painful skin, and large s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Staphylococcus Aureus
''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe, meaning that it can grow without oxygen. Although ''S. aureus'' usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. ''S. aureus'' is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant ''S. aur ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pemphigus Vulgaris
Pemphigus vulgaris is a rare chronic blistering skin disease and the most common form of pemphigus. Pemphigus was derived from the Greek word ''pemphix'', meaning blister. It is classified as a type II hypersensitivity reaction in which antibody, antibodies are formed against desmosomes, components of the skin that function to keep certain layers of skin bound to each other. As desmosomes are attacked, the layers of skin separate and the clinical picture resembles a blister. These blisters are due to acantholysis, or breaking apart of intercellular connections through an autoantibody-mediated response. Over time the condition inevitably progresses without treatment: lesions increase in size and distribution throughout the body, behaving physiologically like a severe burn. Before the advent of modern treatments, mortality for the disease was close to 90%. Today, the mortality rate with treatment is in the range of 5% to 15%, after the introduction of corticosteroids as primary tr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pemphigus Foliaceus
Pemphigus foliaceus is an autoimmune blistering disease of the skin. Pemphigus foliaceus causes a characteristic inflammatory attack at the subcorneal layer of epidermis, which results in skin lesions that are scaly or crusted erosions with an erythematous (red) base.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). Page 558–562. McGraw-Hill. . Mucosal involvement is absent even with widespread disease. If there is an autoimmune IgG buildup in the epidermis, then nearly all of the antibodies are aimed against desmoglein 1. The effect of the antibodies and the immunological pathway is most likely one of three mechanisms: * Steric hindrance of the desmoglein 1: The antibody caps off the site for intracellular binding to another keratinocyte. * Activation of an endocytic pathway: The antibody activates a pathway which causes an internalization of desmogleïn 1, which in turn causes a loss of adhesion. * Disruption of function: In this case, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Cicatricial Pemphigoid
Mucous membrane pemphigoid is a rare chronic autoimmune subepithelial blistering disease characterized by erosive lesions of the mucous membranes and skin. It is one of the pemphigoid diseases that can result in scarring. Signs and symptoms The autoimmune reaction most commonly affects the oral mucosa in the mouth, causing lesions in the gums (gingiva), known as desquamative gingivitis. More severe cases can also affect areas of mucous membrane elsewhere in the body, such as the sinuses, genitals, anus, and cornea. When the cornea of the eye is affected, repeated scarring may result in blindness. ''Brunsting–Perry cicatricial pemphigoid'' is a rare variant of mucous membrane pemphigoid involving the scalp and the neck without mucosal involvement. It is proposed by some authors that this be called a variant of epidermolysis bullosa acquisita. Nikolsky's sign (gentle lateral pressure) on unaffected mucosa or skin raises a bulla. If no lesions are present on examination it ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bullous Pemphigoid
Bullous pemphigoid (a type of pemphigoid) is an autoimmune pruritic skin disease that typically occurs in people aged over 60, that may involve the formation of blisters ( bullae) in the space between the epidermal and dermal skin layers. It is classified as a type II hypersensitivity reaction, which involves formation of anti-hemidesmosome antibodies, causing a loss of keratinocytes to basement membrane adhesion. Signs and symptoms Clinically, the earliest lesions may appear as a hives-like red raised rash, but could also appear dermatitic, targetoid, lichenoid, nodular, or even without a rash ( essential pruritus). Bullous Pemphigoid, is characterized by the subepidermal blisters resulting in tense and less fragile bullae. Tense bullae eventually erupt, most commonly at the inner thighs and upper arms, but the trunk and extremities are frequently both involved. Any part of the skin surface can be involved. Oral lesions are present in a minority of cases. The disease may be a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
