-Dr.

Pallavi Ailawadi

DERMATOLOGY

KEY POINTS »

ACNE
Comedones are characteristic of: Acne vulgaris Comedones
are:
1. Small cysts,
2. formed in follicles,
3. due to blockage of the follicular orifice
4. by the retention of sebum & keratinous material
Acne vulgaris is caused by: Obstruction of pilosebaceous duct Treatment
of NA: Isotretinoin (synthetic retinoic acid)

NAILS INVOLVEMENT
Pterygium of nail is seen in: Lichen planus
Oncholysis is seen in: Psoriasis
Mees line is seen in: Arsenic poisoning
Oil drop, pitting of nails is seen in: Psoriasis
Tinea unguum affects: Nail plate
Koilonychia: Iron deficiency anemia
Koenen's periungal fibroma: Tuberous sclerosis

SCABIES
Genital ridge forms: Ovary
Pathognomic lesion of scabies: Burrows
Location of burrow (layer of skin): Stratum corneum
MC site of scabies in infants: Scalp, Face
Most severe form of scabies: Norwegian scabies Drug
used orally for scabies: Ivermectin

PSORIASIS
MC on: Extensor aspect
Koebner's phenomenon/ KP: Traumatized lesions develops psoriatic lesion (Lesion at the site
of injury)
 -Dr. Pallavi Ailawadi

KP is also seen with: Lichen planus, Lichen sclerosus, Vitiligo etc.

Histopathological lesion in psoriasis: Micro-Munro abscesses (St. corneum)
Rare but sever form of psoriatic arthritis: Arthritis mutilans
Auspitz sign seen in psoriasis is: Rubbing of skin leading to removal of scales resulting in
pinpoint bleeding
Treatment of choice for
Pustular ps - Acitretin
Erythrodermic ps - methotrexate
Phototherapy of choice – NBUVB

PEMPHIGUS
MC form of pemphigus: P. Vulgaris
Etiopathology of pemphigus: Autoimmune disease
Antibodies against intercellular substance (antibodies attacks Desmoglein 3) Feature
of pemphigus:
1. Intraepidermal (flaccid) Acantholytic bullae
2. Oral mucosal lesion
Acantholysis is seen in epidermis (breaking apart of epidermal cells)
Tense subepidermal bullae are seen in Pemphigoid (NOT pemphigus)
Nikolsky sign is positive
Defintive diagnosis of pemphigus: Demonstration of Anti-desmoglein autoantibodies by Direct
immunofluorescence on Skin biopsy

LICHEN PLANUS
Features of lichen planus:
1. Flat topped papules
2. With white lacy markings on mucosa (Wickham's striae)
3. Civatte bodies &
4. Basal cell degeneration
PITYRIASIS ROSACEA
Terms associated with pityriasis rosacea:
1. Herald patch
2. Collaratte of scales

TINEA
Dermatophyte: Parasitic fungus/ mycosis, that infects the skin
It involve the imperfect fungi of tile genera (epidermophyton, microsporum, trichophyton)
Dermatophyte are anamorphic (asexual/ imperfect)
 -Dr. Pallavi Ailawadi

Dermatophytes causes infection of skin, hair & nails due to their ability to obtain
nutrients from keratinized
material
Athlete's foot/ Tinea pedis presents as (Does not affect only athletes):
1. Severe itching
2. Hyperhydrosis
Onycho-mycosis/ Tinea unguum/ Ringworm of the nail affects: Nail plate
Dhobi itch or jock itch is also known as: Tinea cruris
Tinea versicolor/ versatile colour
1. Caused by Malassezia globosa (Dimorphic, lipophilic organism)
2. Griseofulvin and terbinafine by ineffective (Ketoconazole &
Itraconazole are systemic therapy)

ATOPIC DERMATITIS
Also known as: Itch disease
Childhood & adolescent pattern of atopic dermatitis is marked by:
Flexural skin dermatitis
Particularly in the ante-cubital fossa/ popliteal fossa Other
features of AD:
Perioral pallor,
Dennies line,
Increased palmar markings etc.
Best test to diagnose AD: Clinical examination Berloque
dermatitis is due to: Cosmetics

MYCOSIS FUNGOIDES
Mycosis fungoides is also known as: Cutaneous T cell lymphoma,
Special features:
1. MC skin lymphoma,
2. Pautrier's microabscesses
3. Presents with diffuse erythroderma

DERMATITIS HERPETIFORMIS
DH is associated with: Gluten sensitive enteropathy (subclinical) DH
is associated with HLA:
1. HLA-B8/ DRw3
2. HLA-DQw2
 -Dr. Pallavi Ailawadi

Direct immunofluorescence microscopy of normal appearing peri-lesional skin in DH shows:

Granular
deposits of IgA DOC
for DH: Dapsone

ACANTHOSIS NIGRICANS
Characteristic of acanthosis nigricans:
1. Dark,
2. Thick,

Velvetty skin (in body folds & creases)

MC cause of acanthosis nigricans: Type 2 DM

Internal malignancies associated with acanthosis nigricans: Adenocarcinoma lungs,

Carcinoma GIT etc.

LEPROSY NIGRICANS
Associated cells: Virchow cells
1st line of drugs:
1. Rifampicin,
2. Clofazimine,
3. Dapsone
DOC in neuritis: Steroids
Treatment of nerve abscess: steroids. If no improvement - Incision & drainage
MC nerve involved: Ulnar nerve (2nd is posterior auricular nerve)
Organs not involved in leprosy:
1. Ovary,
2. Lungs,
3. CNS
MC type of leprosy in India: BT

Lepromin test indicates: Strong immunity

Lucio's phenomenon: M. leprae may be associated with cutaneous ulcerations in patients
with lepromatous
Leprosy

LEPROMATOUS LEPROSY
Features:
 -Dr. Pallavi Ailawadi

1. Gynaecomastia,
2. Madrosis,
3. Collapse of nasal bridge
Histology: Dermis contains characteristic highly vacoulated cells (Foam cells) (ABSENT/ few
non-caseating
granuloma)

LEPRA REACTION
1. Type II (ENL):
2. Type III hypersensitivity reaction,
3. Thalidomide is effective
4. Type I
5. Type IV hypersensitivity reaction
6. DOC for type I lepra reaction :Corticosteroids

TB SKIN
1. Lupus vulgaris is: Skin TB with no underlying active focus
2. Skin TB secondary to involvement of underlying structure i.e. joint, lymph node is:
Scrofuloderma
3. MC type of cutaneous TB: Lupus vulgaris
4. Form of post primary TB with good resistance: TB verrucosa cutis (TB bacillus are
inoculated into skin; seen
5. in TB patient, pathologists, veterinary surgeons)

STAPH AUREUS
1. SSSS (Staphylococcal scalded skin syndrome),
2. Bullous impetigo/ Impetigo contagiosa,
3. Furuncles/ Boils,
4. Sycosis barbae & Sycosis nuchae

CONDITIONS & IMPORTANT FINDINGS

1. Tuberous sclerosis:
2. Ash leaf spot,
3. Adenoma sebaceum
4. Shagreen patches
5. Urticaria pigmentosa: Darrier's sign
6. Amyloidosis: Pinch purpura
7. Lichen planus:
 -Dr. Pallavi Ailawadi

8. Wickham's striae,
9. Civatte bodies
10. Atopic dermatitis: Dennie Morgan folds
11. Pityriasis rosacea:
12. Herald patch, Mother patch
13. Annular collratte of scales

DERMATOLOGICAL SIGNS & CONDITIONS

1. Casal's necklace: Pellagra
2. Berloque dermatitis: Cosemtics
3. Calcinosis cutis: Scleroderma
4. Crocodile skin: Icthyosis
5. Iris pearls: Leprosy
6. Obstruction of pilo-sebaceous glands: Acne vulgaris
7. Micro-Munro abscess: Psoriasis
8. Pautrier microabscess: Mycosis fungoides
9. Max Joseph space: Lichen planus
10. Basal layer degeneration/ Hydropic degeneration/ Liquefaction degeneration: Lichen
planus (also in DLE,
11. pemphigus etc.)
12. Asboe Hansen sign (bulla spread sign): Pemphigus
13. Dubios sign: Congenital syphilis
14. Ollendroff sign: Secondary syphilis

Summary
1. Acantholysis is seen in: Pemphigus
2. Hidradenitis suppurativa is infection of: Apocrine glands
3. Hypertrophy of sebaceous gland is known as: Rhinophyma
4. Exclamation mark sign is suggestive of: Alopecia areata
5. Mees line on nails is seen in: Arsenic poisoning
6. LGV is caused by: Chlamydia trachomatis
7. Pathognomic lesion of scabies: Burrows
8. Oral drug for scabies: Ivermectin
9. Auspitz sign is seen in: Psoriasis
10. Nikolsky sign is positive in: Pemphigus
11. Herald patch is seen in: Pityriasis rosea
12. Tinea versicolor is caused by: Malassezia globosa
13. Dermatitis herpetiformis is associated with: Celiac disease
14. MC cause of acanthosis nigricans: Obesity

17. HLA associated with Reiters syndrome: HLA B27

18. Dennie Morgan fold is associated with: Atopic dermatitis
 -Dr. Pallavi Ailawadi

19. Histological feature of psoriasis: Micro Munro abscess

20. 4 D's are associated with niacin deficiency
21. Nail changes in lichen planus: Pterygium
22. Ash leaf spot & shagreen patches are associated with: Tuberous sclerosis
23. Pautriers microabscess is associated with: Mycosis fungoides
24. Wickhams striae is associated with: Lichen planus
25. Site of injury may develop psoriatic lesions. This is known as: Koebner's phenomenon