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Drug of Choice Cheatsheet — Dermatology Focus (MRCP Part 1)

TL;DR

This drug of choice cheatsheet summarises the most frequently tested dermatology treatments for MRCP Part 1, focusing on first-line therapy, key alternatives, and common exam traps. Use it to avoid over-treating, pick guideline-correct answers, and secure easy marks in SBA questions.


Why this topic matters for MRCP Part 1

“Drug of choice” questions are among the highest-yield scoring opportunities in MRCP Part 1. Dermatology appears deceptively simple, yet many candidates lose marks by selecting advanced or inappropriate therapies when the exam is clearly testing first-line management.

The exam blueprint rewards:

  • Conservative, guideline-based treatment

  • Correct matching of severity, site, and setting

  • Avoidance of unnecessary systemic therapy

This article supports the wider MRCP Part 1 revision hub and should be used alongside structured revision and question practice:


Scope of this cheatsheet

Included

  • Common inflammatory dermatoses

  • Skin infections frequently tested in SBAs

  • Blistering and immune-mediated disease (core concepts)

Not included

  • Rare biologics and tertiary-centre protocols

  • Procedural detail (biopsy techniques, phototherapy logistics)

  • Cosmetic dermatology


High-yield dermatology: drug of choice table

Condition

Drug of choice (exam)

Key alternative(s)

Exam tip

Atopic eczema flare

Topical corticosteroid (appropriate potency)

Topical tacrolimus

Emollients are baseline, not DOC for flares

Chronic plaque psoriasis (mild–moderate)

Topical steroid + vitamin D analogue

Coal tar

Avoid oral steroids (rebound risk)

Acne vulgaris (moderate)

Oral doxycycline + topical retinoid

Lymecycline

Combine with benzoyl peroxide

Impetigo (localised)

Topical fusidic acid

Oral flucloxacillin

Oral therapy if extensive

Cellulitis (non-purulent)

Flucloxacillin

Clarithromycin

Streptococci most likely

Scabies

Permethrin 5% cream

Oral ivermectin

Treat all close contacts

Tinea corporis

Topical terbinafine

Topical azole

Steroids worsen infection

Onychomycosis

Oral terbinafine

Itraconazole

Confirm with nail clippings

Chronic urticaria

Non-sedating antihistamine

Up-dosing antihistamine

Steroids short-term only

Pemphigus vulgaris

Systemic corticosteroids

Azathioprine

Mucosal involvement is key

MRCP Part 1 candidate revising drug of choice dermatology topics using study notes”

The 5 most tested dermatology subtopics

  1. Eczema management – steroid potency by body site

  2. Psoriasis therapy – topical first, systemic last

  3. Acne algorithms – stepwise escalation

  4. Bacterial vs fungal infection – antibiotics ≠ antifungals

  5. Blistering disorders – pemphigus vs bullous pemphigoid


Mini-case (classic SBA style)

A 22-year-old man presents with itchy, erythematous plaques in the antecubital fossae and behind the knees. He has a history of allergic rhinitis. There is no infection.

Most appropriate treatment? Answer: Topical corticosteroid.

Explanation: This is an atopic eczema flare. Emollients are essential baseline therapy but do not treat inflammation during a flare. Topical calcineurin inhibitors are alternatives for sensitive sites or steroid-sparing use.


Five common exam traps

  • Choosing oral steroids for chronic plaque psoriasis

  • Treating tinea with topical steroids (tinea incognito)

  • Forgetting to treat household contacts in scabies

  • Starting isotretinoin for moderate acne

  • Using adrenaline for isolated urticaria without anaphylaxis

Practical MRCP Part 1 study checklist

  • Learn first-line treatment before alternatives

  • Always match drug choice to severity and setting

  • Ask: “Is this a primary care scenario?”

  • Link therapy to pathophysiology, not appearance alone

  • Reinforce lists with SBA practice

Targeted practice is essential:


How to use this cheatsheet effectively

  • Revise in short, repeated bursts

  • Cover the table, then immediately answer 20–30 SBAs

  • Maintain an “error list” for repeated mistakes

  • Revisit weekly until drug selection becomes automatic

For structured pacing, integrate this into your full revision plan:https://crackmedicine.com/mrcp-part-1/


FAQs

Is dermatology high yield in MRCP Part 1?

Yes. Dermatology provides frequent SBAs that test first-line management and are relatively easy to score with focused revision.

Do I need to memorise biologics?

No. Understanding indications is sufficient. Exams favour conservative, guideline-based therapy.

How do I avoid over-treating in answers?

Pay attention to severity descriptors. Mild or moderate disease almost never needs systemic therapy.

Are NICE guidelines followed exactly in exams?

Yes, broadly. MRCP questions are aligned with NICE and UK specialty guidance.

What’s the fastest way to master drug of choice questions?

Active recall from tables plus immediate SBA practice with feedback.


Call to action

Save this cheatsheet, then test it today with Free MRCP MCQs. When ready, benchmark your timing and accuracy—Start a mock test.


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