During examination of a patient with flaccid blisters, the examiner applies gentle vertical pressure over the centre of an intact bulla, and the blister visibly extends laterally into the adjacent skin. This manoeuvre demonstrates which sign?

• A Asboe-Hansen sign ✓
• B Nikolsky sign
• C Darier sign
• D Auspitz sign

Explanation

The Asboe-Hansen sign, also called the bulla spread sign, is extension of an intact blister when firm vertical pressure is applied over its top. The Nikolsky sign differs in technique: tangential pressure applied to normal-looking perilesional or remote skin shears off the epidermis. Darier sign refers to urtication of mastocytosis lesions on rubbing, and Auspitz sign is pin-point bleeding after removal of psoriatic scale. Both signs indicate severe acantholysis in pemphigus.

Reference: Fitzpatrick's Dermatology, 9th ed.

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