DERMATOLOGY

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DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

CONTENTS
GENERAL ANATOMY AND APPENDAGEAL DISORDERS ................................................................................................. 6
DEVELOPMENT OF SKIN ............................................................................................................................................ 6
GENERAL ANATOMY ................................................................................................................................................. 6
GENERAL FEATURES OF SKIN DISEASES .................................................................................................................... 7
ACNE ......................................................................................................................................................................... 8
DISEASES OF SWEAT GLAND ..................................................................................................................................... 9
DISEASES OF HAIR ..................................................................................................................................................... 9
DISORDERS OF NAIL ................................................................................................................................................ 10
PHOTOTOXICITY ...................................................................................................................................................... 11
ALLERGIC DISORDERS.................................................................................................................................................. 11
GENERAL FEATURES OF ALLERGIC DISORDERS OF SKIN ......................................................................................... 11
ATOPIC DERMATITIS ............................................................................................................................................... 12
UTRICARIA ............................................................................................................................................................... 13
HEREDITARY ANGIOEDEMA .................................................................................................................................... 13
ANAPHYLAXIS .......................................................................................................................................................... 13
DISORDERS OF SKIN PIGMENTATION ......................................................................................................................... 14
GENERAL FEATURES OF PIGMENT RELATED SKIN DISORDERS ............................................................................... 14
VITILIGO .................................................................................................................................................................. 15
PITYRIASIS ROSACEA ............................................................................................................................................... 15
PITYRIASIS RUBRA PILARIS ...................................................................................................................................... 16
TINEA VERSICOLOR ................................................................................................................................................. 16
PITYRIASIS ALBA ...................................................................................................................................................... 16
FUNGAL INFECTIONS OF SKIN ..................................................................................................................................... 17
GENERAL FEATURES OF FUNGAL SKIN INFECTIONS ................................................................................................ 17
TINEA CAPITIS ......................................................................................................................................................... 17
TINEA CORPORIS ..................................................................................................................................................... 18
TINEA CRURIS .......................................................................................................................................................... 18
TINEA BARBAE ......................................................................................................................................................... 18
TINEA PEDIS ............................................................................................................................................................ 18
TINEA UNGUIM ....................................................................................................................................................... 18
CANDIDIASIS ........................................................................................................................................................... 18
SPOROTRICHOSIS .................................................................................................................................................... 18

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DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

WOODS LAMP AND UV LIGHT................................................................................................................................ 19

PAPULOSQUAMOUS DISORDERS ................................................................................................................................ 19
GENERAL FEATURES OF PAPULOSQUAMOUS DISORDERS ..................................................................................... 19
PSORIASIS ................................................................................................................................................................ 19
PSORIATIC ARTHRITIS .............................................................................................................................................. 21
PUVA THERAPY ....................................................................................................................................................... 21
LICHEN PLANUS ....................................................................................................................................................... 21
BULLOUS DISORDERS .................................................................................................................................................. 22
GENERAL FEATURES OF BULLOUS DISORDERS ....................................................................................................... 22
PEMPHIGUS............................................................................................................................................................. 23
EPIDERMOLYSIS BULLOSA ....................................................................................................................................... 24
PEMPHIGOID ........................................................................................................................................................... 24
DERMATITIS HERPETIFORMIS ................................................................................................................................. 24
LINEAR IGA DISEASE ................................................................................................................................................ 25
SCABIES AND PEDICULOSIS ......................................................................................................................................... 25
SCABIES ................................................................................................................................................................... 25
PEDICULOSIS ........................................................................................................................................................... 26
SYSTEMIC AND PHOTOSENESITIVE DISORDERS .......................................................................................................... 26
GENERAL FEATURES OF SYSTEMIC AND PHOTOSENSITIVE DISORDERS ................................................................. 26
DERMATOMYOSITIS ................................................................................................................................................ 27
PORPHYRIA.............................................................................................................................................................. 27
CHLOASMA.............................................................................................................................................................. 28
POLYMORPHIC LIGHT REACTION ............................................................................................................................ 28
PHOTOSENSITIVE DERMATITIS................................................................................................................................ 28
FIXED DRUG ERUPTION ........................................................................................................................................... 28
ERYTHEMA NODOSUM ........................................................................................................................................... 28
SKIN TUBERCULOSIS ................................................................................................................................................ 29
INFECTIVE DISEASES OF SKIN ...................................................................................................................................... 29
COMMON INFECTIVE DISEASES OF SKIN ................................................................................................................ 29
ERYTHEMA MULTIFORME ....................................................................................................................................... 30
STAPHYLOCOCCAL SCALDED SKIN SYNDROME ....................................................................................................... 31
STEVEN JOHNSON SYNDROME ............................................................................................................................... 31
TOXIC EPIDERMONECROLYSIS ................................................................................................................................ 31
MOLLUSCUM CONTAGIOSUM ................................................................................................................................ 31
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DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

HERPES ZOSTER ....................................................................................................................................................... 31

MALIGNANT SKIN DISEASES ........................................................................................................................................ 32
GENERAL FEATURES OF MALIGNANT SKIN DISEASE ............................................................................................... 32
ACANTHOSIS NIGRICANS ........................................................................................................................................ 33
MYCOSIS FUNGOIDES ............................................................................................................................................. 34
HISTIOCYTOSIS ........................................................................................................................................................ 34
BASAL CELL CARCINOMA ........................................................................................................................................ 35
FEATURES OF MALIGNANT MELANOMA ................................................................................................................ 35
MANAGEMENT OF MALIGNANT MELANOMA ........................................................................................................ 36
GENODERMATOSES .................................................................................................................................................... 37
XERODERMA PIGMENTOSA .................................................................................................................................... 37
INCONTINENTIA PIGMENTI ..................................................................................................................................... 37
NEUROFIBROMATOSIS ............................................................................................................................................ 37
TUBEROUS SCLEROSIS ............................................................................................................................................. 38
ICHTHYOSIS ............................................................................................................................................................. 38
LEPROSY ...................................................................................................................................................................... 39
MYCOBACTERIUM LEPRAE ...................................................................................................................................... 39
EPIDEMIOLOGY OF LEPROSY ................................................................................................................................... 39
CLASSIFICATION OF LEPROSY .................................................................................................................................. 40
FEATURES OF LEPROSY ........................................................................................................................................... 40
LEPROMIN TEST ...................................................................................................................................................... 42
DIAGNOSIS OF LEPROSY .......................................................................................................................................... 42
TREATMENT OF LEPROSY ........................................................................................................................................ 42
LEPRA REACTIONS ................................................................................................................................................... 43
SEXUALLY TRANSMITTED DISEASES ............................................................................................................................ 44
GENERAL FEATURES OF SEXUALLY TRANSMITTED DISEASES ................................................................................. 44
WARTS..................................................................................................................................................................... 45
GONORRHOEA ........................................................................................................................................................ 46
LYMPHOGRANULOMA VENERUM .......................................................................................................................... 46
DONOVANOSIS ........................................................................................................................................................ 47
CHANCROID ............................................................................................................................................................ 47
HERPES .................................................................................................................................................................... 48
SYPHILIS ...................................................................................................................................................................... 48
TREPONEMA PALLIDUM ......................................................................................................................................... 48
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DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

GENERAL FEATURES OF SYPHILIS ............................................................................................................................ 49

CONGENITAL SYPHILIS ............................................................................................................................................ 50
PRIMARY SYPHILIS ................................................................................................................................................... 50
SECONDARY SYPHILIS .............................................................................................................................................. 50
TERTIARY SYPHILIS .................................................................................................................................................. 51
DIAGNOSIS OF SYPHILIS .......................................................................................................................................... 51
TREATMENT OF SYPHILIS ........................................................................................................................................ 52

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DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

KEY TO THIS DOCUMENT

Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
text book of internal medicine 18th
edition
Text in italic font Can be read if
you are thorough with above two

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GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DERMATOLOGY

GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DEVELOPMENT OF SKIN
Melanoblast cells appear in basal layer of epidermis
Dermal and Epidermal melanoblasts are formed from

rd

3 month of intrauterine life

Neural Crest

GENERAL ANATOMY
Normal Skin Cycle (Turn over time of epidermis)
Epithelium of Skin
Nutrition to epidermis is derived from
Odland bodies is seen in
Odland body is
Keratin is produced from
Keratohyaline granules are seen in
Important layer in regulating permeability
NOT true about granular layer of skin
Under Developed Layer in VLBW babies
Stratum lucidum
Melanocytes are present in
Highest concentration of melanocyte
Epidermal melanin unit
Melanin in melanocyte is stained with
Immigrant cells
Merkel cells are derived from
Stem cells of skin are seen in
Immunocompetent cells of skin
Hallmark of epidermal cells
Seen in basal epidermis
Blaschko Lines
Blaschko line pattern is visible in
Neither raised Nor depressed
Flat discolouration on skin as 1 cm is called
NOT a primary skin lesion
Parakeratosis
Henles and Huxleys layer are histologically seen in
Holocrine secretion seen in
Normal microbial flora in skin and mucous membrane
Normal commensals of skin

28 days
Stratified squamous epithelium
Diffusion from capillary plexus in dermis
Stratum granulosum
Keratinosome
Stratum granulosum
Stratum granulosum
Stratum granulosum
It is the terminal layer of differentiation
Stratum corneum
Sandwiched between S.corneum and S.granulosum,
contains degenerated cells
Stratum basale
Face
1 melanocyte with 36 keratinocytes
Mason Fontana stain
Melanocytes and merkel cells
Neural crest
Hair follicle bulge, Interfollicular region, Sebaceous
gland
Langerhan cells
Keratin filaments
Keratinocyte, melanocytes, langerhan cells, merkel cells
Developmental lines, NOT dermatome, DIFFERENT from
nervous, vascular, lymphatics
Lichen striatum, incontinenta pigmenti,
scarlet fever, sarcoidosis
Macule
Macule
Abscess, crust
Nuclei retained in stratum corneum
Bulb of hair follicle
Sebaceous gland
It establishes in body only after the neonatal period
Staphylococcus aureus, Candida albicans,
Propioibacterium, Corynebacterium, Streptococcus,
Diphtheroids

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GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DERMATOLOGY
Normal commensals of skin

Candida, Propionibacterium acne

GENERAL FEATURES OF SKIN DISEASES

Intrinsic causes of skin disease
Dermatitis that occur due to plant
derived phytophotoxic substance
Chemical agents causing dermatitis by local irritation
Dermatitis may be clinical manifestation of deficiency of
Greasy yellowish scale is associated with
Red dermatographism is seen in
MC form of seborrheic dermatitis affecting
trunk
Cradle cap
MC occupational disease
Primary skin lesion
Secondary skin lesion
Annular means
Herpetiform means
Milia
Nummular
Spongiosis seen in
Spongiosis means
Characteristic Finding of Eczema
Winter itch is also known as
Dermatosis Papulosis Nigra
Sign of Leser Trelat
Cayenne pepper spots
Pentasomida
Fordycees spots in oral cavity arise from
Fordycee spot
Fordycee spot mainly involve
Acrochordon
Exposure to sunlight can precipitate
Discoid lupus erythematosus
Cyanne pepper appearance on diascopy
Chloroquine is indicated in treatment of
Predominant acral eruptions are seen in
Severe in rainy season and improved completely in
winter
Erythematous papule with central punctum
Morbilliform eruption is seen in
Hives and wheels caused by
Pruritis is NOT seen in
A young boy with rashes on web spaces and penis
Lichen sclerosis

Atopic dermatitis, Pityriasia alba, Seborrhoic dermatitis

Phytophotodermatitis
Rubber, X rays, lime
Biotin, niacin, pyridoxine
Seborrhoeic dermatitis
Seborrheic dermatitis
Petaloid
Infantile seborrhoeic dermatitis
Dermatosis
Plaque - > 1 cm flat topped seen in psoriasis and exfoliative
dermatitis, tumor - > 5 cm solid
Scale excessive accumulation of stratum corneum
ring
Grouped
Small, firm papules with keratin
Coin
Acute eczema
Intercellular edema of epidermis
Lichenification
Asteatotic eczema, Xerotic eczema
Seborrheic keratosis
Seborrhoeic keratosis
Dermatosis
Tongue worm
Sebaceous gland
Ectopic sebaceous gland found in healthy people
Lip > buccal mucosa
Skin tag, fleshy papules
Discoid lupus erythematosus
Also known as chronic cutaneous lupus erythematosus,
hyperkeratosis, follicular plugging, atrophy
Discoid lupus erythematous
DLE
RMSF, secondary syphilis, erythema
multiforme
Insect bite allergy
Insect bite
Rubella, measles
Cold, hepatitis C, serum sickness
Pemphigus
Lichen nitidus
Atrophy of epidermis with dermal fibrosis

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GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DERMATOLOGY
Calcifying epithelioma
Firm red to brown nodule that shows dimpling of overlying
skin with lateral compression
Recurrent oral ulcers with pain and erythematous halo
around them
Cayenne pepper strippling due to hemosiderin is found
in
Keratoderma seen in
Veldt sore is common in
Change seen in Poikiloderma
MC site of felon
Boil can NOT occur at
Diascopy
Diascopy is useful in
Treatment of erythematous skin rash with multiple pus
lakes in a pregnant woman
Itchy exudative lesions on face, palms and soles, siblings
also have similar complaints. treatment of choice in
such patient
Drug of choice of Chronic folliculitis
NOT a keratolytic agent
PUVA therapy is indicated in
Dermabrasion is contraindicated on
Crystal used in microdermal abrasion
Commonly used depilating agent

Dermatofibroma
Dermatofibroma
Aphthous ulcer
Plasma cell balanitis of zoon
Pityriasis rubra pilaris, Reiter syndrome
Deserts
Atrophy, Telangiectasia, Pigmentary changes
Thumb
Palm
Skin blanch with pressure or not
Lupus vulgaris, cutaneous vasculitis,
nevus anemicus
Corticosteroids
Systemic ampicillin

Cloxacillin
Zinc oxide
Psoriasis, Vitiligo, Atopic dermatitis
Eyelids, Pyoderma skin infection, Skin with severe
radiation dermatitis, Basal cell carcinoma
Aluminium oxide
Thioglycolate

ACNE
Iodine toxicity causes
Causes of acneiform eruption
NOT a cause of acneiform eruption
NOT a causative factor for acne
Not involved in etiopathogenesis of acne
Acne Vulgaris is due to
Comedones are characteristic of
19 years female, multiple papulopustular erythematous
lesion on face and neck
Acne acuminata is found in
Steroid acne
Middle aged male with recurrent abscess
and discharging sinus and fibrosis over
axilla
Drug used for Acne
Oral retinoids used in treatment of

Acne like eruption

Cryptococcus, acne rosacea, Behcets
disease
Sarcoidosis
Only food
Colonization of staphylococcus aureus
Obstruction of Pilosebaceous gland
Acne vulgaris
Acne vulgaris
Tuberculosis
Absence of comedones, occasional pruritis,
absence of nodulocystic lesion
Acne inversa

Retinoids
Acne vulgaris

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GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DERMATOLOGY
Treatment of acne
Treatment of choice in acne
Recalcitrant pustular acne treated by
Acne with Inflammatory Lesions
Treatment of inflammatory acne
Treatment of comedonal acne
Drug of choice for 24 year old unmarried woman having
multiple nodular cystic, pustular comedonic lesions on
face, upper back and shoulder for 2 years
Treatment of nodulocytic acne
Treatment of choice in Nodulocystic acne
MC complication of synthetic retinoid
Isotretinoin

Drug of choice in a teenager girl with moderate acne

also complaining irregular menses
NOT a treatment of acne vulgaris
NOT an useful form of Vitamin A

13 cis retinol, minocycline, erythromycin

Topical Isotreitoin and Doxycycline
Retinoid
Oral Doxycycline
Minocycline
Retinoids
Isotretinoin

Isotretinoin
Retinoic acid
Dry mouth and skin rash
Can cause rosacea, can cause permanent
skin thinning, should not be used with
tetracycline
Cyproterone acetate
Androgen
Retinoic acid

DISEASES OF SWEAT GLAND

Key role in sweating
Acetylcholine acts as a postganglionic
sympathicomimetic of
Sweat gland of palm can be differentiated from others
by
Apocrine gland
Hidrandenitis suppurativa is infection of
Hidradenitis suppurative commonly
affects
Hidradenitis suppurativa NOT found in
Miliaria is a disease of
Crystalline miliaria is due to obstruction of
Miliaria crystalline affects
Bromhidrosis produced by intake of
Fox fordycee spot
Apocrine miliaria

Hypothalamic preoptic nucleus

Sweat glands
Secretion stimulated by emotional stimuli
Modified sweat gland, present in groin and axilla,
infection is known as hidradenitis suppurativa
Apocrine glands
Axilla
Scalp
Eccrine gland
Sweat glands
Stratum corneum
Onion, garlic, asafoetida
Common in adult woman, common in axilla and areola
Fox fordycee disease

DISEASES OF HAIR
Hair bulb is situated in
Commonly noticed feature in preterm infants
Lanugo Hair appears at
Factor promoting hair growth in female
Hair Growth in girls is NOT

Upper part of subcutaneous fat

Lanugo hair
4 months
Testosterone
Estrogen dependent

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GENERAL ANATOMY AND APPENDAGEAL DISORDERS

DERMATOLOGY
After death, hair become loose by
Hair Cycle
Anagen phase of hair
Time period between physical emotional stress and hair
loss
22 year woman, diffuse hair loss one month, past
history of enteric fever, before 4 months
Scarring alopecia/Cicatrical alopecia
Pseudopelade is a synonym for
Cicatrical alopecia with blue grey patches
hyperpigmentation is commonly associated with
NON cicatrical alopecia
MC type of non scarring alopecia
NON scaring alopecia
Alopecia neoplastica
Alopecia areata presumed to be
Patchy loss of hair on scalp, eyebrows, beard, history of
rapid graying of hair in a few areas
Exclamation hair mark, Going grey overnight
Sand paper appearance of nail
Not associated with alopecia areata
Treatment of Alopecia areata
Alopecia areata treated by
Greying of hair in a village is mainly due to
7 year old boggy swelling of scalp with multiple
discharging sinus with cervical lymphadenopathy with
easily pluckable hair
KOH mount
Drug useful in treating hair loss
Excessive hair growth is NOT associated with
Man with diffuse hair loss involving crown and frontal
scalp with maintenance of frontal hair line
Drug of choice in androgenic alopecia
Contraindicated in androgenic alopecia
Feature of hypertrichosis that differentiates it from
hirsutism
Hypertrichosis is informally called as
White piedra is caused by
Black piedra is caused by

72 hours
30 days
Phase of activity and growth
3 months
Telogen effluvium
Lichen planus, DLE, SLE
Cicatrical alopecia
Whitish lesion in buccal mucosa
Psoriasis. alopecia areata, androgenic alopecia, SLE
Androgenic alopecia
Alopecia areata
Metastatic tumor hair loss
Autoimmune etiology
Alopecia areata
Alopecia areata
Alopecia areata
Geographic tongue
Whitfield ointment
Minoxidil
Nutritional cause
KOH mount
2 drops of 10 20 % KOH
Minoxidil
Reserpine
Female pattern baldness
Finasteride
Testosterone
Hypertrichosis occurs in forehead and temporal region of
face
Warewolf syndrome
Trichosporum beigelli
Piedra hortae

DISORDERS OF NAIL
Maturity of fetus is most reliably decided by
Nail involvement in
Muehrcke lines are seen in
Terry nails are seen in
Tinea unguim affects
Oncholysis associated with

Nail growth
Psoriasis, lichen planus, fungal infection, alopecia, viral
infection
Hypoalbuminemia
Cirrhosis
Nail plate
Allergic dermatitis, Psoriasis, Antineoplastic therapy
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