Positive Nikolsky's sign is associated with which exfoliative disease?

A positive Nikolsky's sign is described as the skin's tendency to blister or peel when lateral pressure is applied. This phenomenon is particularly relevant in conditions that affect the integrity of the epidermis. In the context of exfoliative diseases, it is most notably associated with Steven Johnson syndrome (SJS) or its more severe counterpart, toxic epidermal necrolysis (TEN).

In SJS, there is a significant detachment of the epidermis due to an underlying inflammatory process, often triggered by medications or infections. The presence of a positive Nikolsky's sign indicates the disruption of the dermal-epidermal junction, which is characteristic of this condition. This sign is less commonly associated with the other options provided, as those conditions generally do not lead to the same level of epidermal separation as seen in SJS.

Erythema multiforme, while being an exfoliative skin condition as well, typically does not present with a positive Nikolsky's sign because the epidermis remains relatively intact compared to SJS. Similarly, psoriasis is characterized by thickened plaques and the skin's structure remains relatively stable under pressure. Contact dermatitis involves an allergic or irritant response that does not disrupt the dermal-epiderm