In Bullous Pemphigoid, is Nikolsky sign positive or negative?

In Bullous Pemphigoid, the Nikolsky sign is negative. This sign tests the skin's tendency to blister upon gentle lateral pressure or friction; when it is positive, the skin will blister easily. In contrast, Bullous Pemphigoid is characterized by subepithelial blistering and the integrity of the epidermal-dermal junction is largely preserved, which means that applying lateral pressure typically does not induce blistering. Thus, the testing of Nikolsky sign yields a negative result in individuals with this condition, indicating that the skin is stable and does not separate easily.

The condition itself is an autoimmune blistering disorder, which differentiates it from other forms of pemphigus where the Nikolsky sign may be positive due to more superficial blister formation. Understanding this distinction is crucial in diagnosing skin disorders effectively.