Final answer:
A 45-year-old male with oral mucosal ulcerations and positive Nikolsky sign most likely has pemphigus vulgaris, an autoimmune blistering disorder requiring immediate medical attention and treatment with immunosuppressants and corticosteroids.
Step-by-step explanation:
The presence of oral mucosal ulcerations and a positive Nikolsky sign in a 45-year-old male may indicate a diagnosis of an autoimmune blistering disorder such as pemphigus vulgaris. Pemphigus vulgaris is characterized by the formation of flaccid blisters on the skin and mucosal surfaces, which can easily rupture leading to painful ulcerations. A positive Nikolsky sign, where the skin or mucosa sloughs off with slight pressure or trauma, supports this diagnosis. Immediate medical attention is required, as the condition can worsen, leading to significant morbidity. Treatment typically involves the use of immunosuppressants and corticosteroids to reduce inflammation and autoantibody production.