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Article
September 1987

Positive Nikolsky's and Bulla-Spread Signs in Acute Bullous Lichen Planus

Author Affiliations

Department of Dermatology, Pathology, and Immunopathology Postgraduate Institute of Medical Education and Research Chandigarh 160012, India

Arch Dermatol. 1987;123(9):1122-1123. doi:10.1001/archderm.1987.01660330029004
Abstract

To the Editor.—  Nikolsky's and bulla-spread signs, originally described by Pyotr Vasilyevich Nikolsky1,2 and G. Asboe-Hansen3 have proved to be reliable diagnostic tests. Although once thought to be the sine qua non of pemphigus, these signs are also elicited in staphylococcal scalded skin syndrome, adult toxic epidermal necrolysis, and certain hereditary blistering diseases.4 We examined a patient with acute generalized lichen planus with bullae in whom these signs were demonstrated. We would like to share our experience through this communication.

Report of a Case.—  Intensely itchy, erythematous, violaceous lesions developed over the feet and legs of a 40-year-old woman. One month later, the lesions progressed over a span of two weeks to involve her whole body. Large blisters and vesicles appeared overlying the preexisting lesions on the sites of friction over her legs, knees, buttocks, and back, and painful ulcers developed. There was pain and discomfort when

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