Articles in Dermatology (3)

Il segno di Nikolsky è una manovra clinica dermatologica in cui una delicata pressione tangenziale applicata sulla cute apparentemente normale o sulle bolle intatte provoca il distacco dell'epidermide superficiale dallo strato basale. Questo reperto indica un'adesione intercellulare compromessa ed è caratteristico di patologie bollose intraepidermiche come il pemfigo volgare e di gravi reazioni avverse da farmaco come la necrolisi epidermica tossica.

Erythema multiforme is an acute, immune-mediated mucocutaneous hypersensitivity reaction characterized by classic targetoid skin lesions and variable mucosal involvement, most commonly triggered by herpes simplex virus or Mycoplasma pneumoniae infections. Diagnosis is primarily clinical, supported by skin biopsy when atypical, and first-line management involves identifying and eliminating triggers alongside symptomatic treatment with topical corticosteroids or systemic antivirals for recurrent disease.

Toxic epidermal necrolysis (TEN) is a life-threatening, severe cutaneous adverse reaction characterized by extensive epidermal necrosis and detachment exceeding 30% of the body surface area, typically triggered by medications. The gold standard for diagnosis is clinical assessment combined with skin biopsy showing full-thickness epidermal necrosis, evaluated alongside the SCORTEN prognostic score for mortality stratification. First-line management mandates immediate withdrawal of the offending culprit drug, emergency transfer to an ICU or specialized burn unit, and multidisciplinary supportive care.