FMGE Dermatology Syllabus

Dermatology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Dermatology in FMGE, not a summary of it.

1. 1

   Introduction to Dermatology

   2 topics

   • Anatomy and physiology of the skin
     • Layers of the skin (epidermis, dermis, subcutaneous tissue)
     • Appendages (hair, nails, sweat glands)
     • Functions of the skin (protection, thermoregulation, sensation)
   • Classification of skin lesions
     • Primary lesions (macule, papule, plaque, nodule, vesicle, bulla)
     • Secondary lesions (scale, crust, erosion, ulcer, atrophy)
2. 2

   Basic Dermatological Procedures

   3 topics

   • Skin Biopsy
     • Techniques (punch biopsy, shave biopsy, incisional biopsy)
     • Indications
     • Interpretation of histopathological findings
   • Patch Testing
     • Diagnosis of allergic contact dermatitis
     • Interpretation of patch test results
   • Dermoscopy
     • Use of dermoscopy for the diagnosis of melanocytic lesions
     • Use of dermoscopy for the diagnosis of non-melanocytic lesions
     • Use of dermoscopy for the diagnosis of inflammatory skin conditions
3. 3

   Inflammatory Skin Disorders

   3 topics

   • Psoriasis
     • Clinical features
     • Plaque psoriasis
     • Guttate psoriasis
     • Pustular psoriasis
     • Topical therapy
     • Phototherapy
     • Systemic therapy
   • Eczema (Atopic Dermatitis)
     • Clinical features
     • Acute eczema
     • Subacute eczema
     • Chronic eczema
     • Emollients
     • Topical corticosteroids
     • Calcineurin inhibitors
   • Acne Vulgaris
     • Pathogenesis
     • Comedones
     • Papules
     • Pustules
     • Nodules
     • Topical retinoids
     • Benzoyl peroxide
     • Oral antibiotics
4. 4

   Infectious Skin Disorders

   3 topics

   • Bacterial infections
     • Impetigo
     • Cellulitis
     • Erysipelas
     • Folliculitis
     • Furuncles
     • Carbuncles
   • Viral infections
     • Herpes simplex virus (HSV) infection
     • Herpes zoster (shingles)
     • Molluscum contagiosum
     • Common warts
     • Plantar warts
   • Fungal infections
     • Dermatophytosis
     • Candidiasis
     • Pityriasis versicolor
5. 5

   Autoimmune and Connective Tissue Disorders

   3 topics

   • Lupus erythematosus
     • Systemic lupus erythematosus (SLE)
     • Discoid lupus erythematosus (DLE)
     • Subacute cutaneous lupus erythematosus (SCLE)
   • Dermatomyositis
     • Clinical features
     • Skin manifestations (heliotrope rash, Gottron's papules)
     • Management
   • Scleroderma
     • Localized scleroderma (morphea)
     • Systemic sclerosis (limited cutaneous, diffuse cutaneous)
6. 6

   Pigmentary Disorders

   3 topics

   • Vitiligo
     • Pathogenesis
     • Clinical features
     • Depigmented macules
     • Patches
     • Topical corticosteroids
     • Phototherapy
   • Melasma
     • Clinical features
     • Topical depigmenting agents
     • Chemical peels
   • Post-inflammatory hyperpigmentation
     • Causes
     • Clinical features
     • Management
7. 7

   Hair and Nail Disorders

   3 topics

   • Alopecia areata
     • Pathogenesis
     • Clinical features (well-defined patches of non-scarring alopecia)
     • Management (topical corticosteroids, intralesional corticosteroids)
   • Androgenetic alopecia
     • Clinical features
     • Pattern of hair loss (male pattern baldness, female pattern hair loss)
     • Management (topical minoxidil, oral finasteride)
   • Onychomycosis
     • Fungal nail infection
     • Clinical features (thickened, discolored nails)
     • Management (oral antifungal therapy, topical therapy)
8. 8

   Genodermatoses

   2 topics

   • Epidermolysis bullosa
     • Clinical features
     • Epidermolysis bullosa simplex
     • Dystrophic epidermolysis bullosa
     • Wound care
     • Genetic counseling
   • Neurofibromatosis
     • Neurofibromatosis type 1 (von Recklinghausen disease)
     • Clinical features
     • Management
9. 9

   Skin Cancer

   3 topics

   • Basal cell carcinoma
     • Clinical features
     • Risk factors
     • Management
   • Squamous cell carcinoma
     • Clinical features
     • Risk factors
     • Management
   • Melanoma
     • Clinical features
     • Staging
     • Management
10. 10

    Cosmetic Dermatology

    3 topics

    • Botulinum toxin injections
      • Indications (dynamic wrinkles)
      • Technique
      • Complications
      • Contraindications
    • Fillers
      • Hyaluronic acid fillers
      • Calcium hydroxylapatite fillers
      • Poly-L-lactic acid fillers
      • Volume restoration
      • Wrinkle correction
    • Chemical peels
      • Superficial peels (alpha hydroxy acids)
      • Medium-depth peels (trichloroacetic acid)
      • Deep peels (phenol)
      • Skin rejuvenation

Dermatology flashcards for FMGE

24 of 51 cards from the Dermatology deck — real questions with worked answers.

1. What are the three main layers of the skin from superficial to deep, and which germ layers do they derive from?

   Epidermis (ectoderm), dermis (mesoderm), and subcutaneous tissue/hypodermis (mesoderm). Melanocytes and nerves are neuroectodermal.

2. Name the five layers (strata) of the epidermis from deep to superficial.

   Stratum basale (germinativum), stratum spinosum, stratum granulosum, stratum lucidum (only in thick/palmoplantar skin), and stratum corneum. Mnemonic: 'Come, Let's Get Sun Burned' (reversed).

3. What is the approximate epidermal turnover (transit) time from basal layer to shedding, and how is it altered in psoriasis?

   Normal turnover is about 28 days; in psoriasis it is drastically accelerated to roughly 3-4 days, causing scaling.

4. Which cell types reside in the epidermis and what is each one's function?

   Keratinocytes (keratin/barrier), melanocytes (melanin), Langerhans cells (antigen presentation), and Merkel cells (touch mechanoreceptors).

5. Define a macule versus a papule.

   A macule is a flat, circumscribed change in skin color <1 cm (a patch if >1 cm). A papule is a solid, raised lesion <1 cm (a nodule if larger/deeper, a plaque if a flat-topped elevation >1 cm).

6. Distinguish a vesicle, bulla, and pustule.

   A vesicle is a fluid-filled blister <1 cm; a bulla is a fluid-filled blister >1 cm; a pustule is a circumscribed lesion filled with pus.

7. Differentiate primary from secondary skin lesions.

   Primary lesions arise de novo from the disease process (e.g., macule, papule, vesicle); secondary lesions result from evolution or external manipulation (e.g., scale, crust, erosion, ulcer, scar, lichenification).

8. What is the difference between an erosion and an ulcer?

   An erosion is loss of epidermis only and heals without scarring; an ulcer is loss extending into the dermis or deeper and heals with scarring.

9. Which skin biopsy technique is best for a deep/subcutaneous panniculitis or evaluating the full skin thickness?

   An incisional or excisional biopsy (or a deep punch reaching subcutaneous fat). Punch and shave biopsies may miss deep pathology.

10. When is a shave biopsy appropriate versus contraindicated?

    Appropriate for raised/superficial/exophytic lesions (e.g., suspected BCC, seborrheic keratosis). Contraindicated when melanoma is suspected, because it can transect the lesion and prevent accurate Breslow depth measurement.

11. What is patch testing used to diagnose, and what type of hypersensitivity does it detect?

    Patch testing diagnoses allergic contact dermatitis, a Type IV (delayed-type, T-cell mediated) hypersensitivity reaction.

12. What is the standard reading schedule for patch test results?

    Patches are applied for 48 hours, then read at 48 hours (initial removal) and again at 72-96 hours (delayed reading) to detect late reactions.

13. What is dermoscopy and what key advantage does it offer?

    Dermoscopy is non-invasive in vivo examination of skin using a magnifying dermatoscope with polarized/immersion light, visualizing subsurface structures (pigment network, vessels) to aid diagnosis of melanocytic and other lesions, improving melanoma detection.

14. On dermoscopy, what is the 'blue-white veil' a clue to?

    A blue-white veil (confluent blue pigmentation with overlying white haze) is a dermoscopic feature suggestive of melanoma.

15. What is the pathophysiologic hallmark of psoriasis on histology?

    Hyperproliferation of keratinocytes with parakeratosis, acanthosis, elongated rete ridges, thinned suprapapillary plates, and neutrophil collections (Munro microabscesses in stratum corneum).

16. What are the Auspitz sign and Koebner phenomenon in psoriasis?

    Auspitz sign = pinpoint bleeding when psoriatic scale is removed (due to thin suprapapillary plates over dilated capillaries). Koebner phenomenon = appearance of new lesions at sites of trauma.

17. Name the classic clinical type and typical distribution of plaque psoriasis.

    Chronic plaque psoriasis (psoriasis vulgaris): well-demarcated erythematous plaques with silvery-white scale on extensor surfaces (elbows, knees), scalp, and lumbosacral region.

18. What cytokine pathway is central to psoriasis and is the target of modern biologics?

    The IL-23/IL-17 (Th17) axis, along with TNF-alpha; biologics target TNF-alpha, IL-12/23, IL-17, and IL-23.

19. What is the underlying barrier/immune defect in atopic dermatitis (eczema)?

    A filaggrin gene mutation causing impaired skin barrier function, combined with a Th2-skewed immune response (elevated IL-4, IL-13, IgE).

20. Describe the age-related distribution of atopic dermatitis.

    Infants: face and extensor surfaces; children/adults: flexural areas (antecubital and popliteal fossae, neck, wrists).

21. What triad of atopic conditions is associated with atopic dermatitis?

    The atopic triad: atopic dermatitis (eczema), allergic rhinitis (hay fever), and asthma.

22. What are the four pathogenic factors in acne vulgaris?

    (1) Increased sebum production (androgen-driven), (2) follicular hyperkeratinization, (3) Cutibacterium acnes (Propionibacterium acnes) colonization, and (4) inflammation.

23. Differentiate open and closed comedones in acne.

    Open comedones = blackheads (dilated follicle with oxidized melanin/keratin); closed comedones = whiteheads (obstructed follicle with a closed surface).

24. What is the first-line oral treatment for severe nodulocystic acne, and what key precaution is required?

    Oral isotretinoin; it is highly teratogenic, requiring strict contraception and pregnancy monitoring (e.g., iPLEDGE), plus monitoring of lipids and liver function.

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