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High-Yield Dermatology for MRCP Part 1

TL;DR

Dermatology contributes a small but predictable portion of MRCP Part 1, and questions are typically pattern-recognition based. This guide summarises the high-yield dermatology for MRCP Part 1, focusing on psoriasis, eczema, drug reactions, bullous disease, and infections. A mini-case and study checklist reinforce rapid recall. Use this as a concise, exam-oriented primer before practising questions and mocks.


Why this matters

Although dermatology forms a modest component of the MRCP Part 1 blueprint (see the official MRCP(UK) content outline: https://www.mrcpuk.org/mrcpuk-examinations/part-1/about-mrcpuk-part-1), the questions are straightforward once you commit key patterns and systemic associations to memory. Many stems assess recognition of classic descriptors—silvery scale, target lesions, tense bullae, or nocturnal pruritus—without requiring image interpretation.

For broader exam structure and pacing strategies, review the Crack Medicine MRCP Part 1 overview:👉 https://crackmedicine.com/mrcp-part-1/


The 5 Most Tested Dermatology Subtopics

1) Psoriasis

A staple of MRCP-style pattern recognition.

Key points

  • Chronic plaque psoriasis: well-demarcated erythematous plaques with silvery scale, usually on extensor surfaces.

  • Nail disease: pitting, onycholysis, oil-drop sign.

  • Guttate psoriasis: classically after streptococcal infection.

  • Triggers: lithium, NSAIDs, antimalarials, infections, steroid withdrawal.

Systemic cluesLinks with psoriatic arthritis, metabolic syndrome, uveitis.

2) Eczema / Dermatitis

Testers like to differentiate atopic, seborrhoeic, and venous eczema.

Key points

  • Atopic dermatitis: flexural, associated with atopy (asthma, allergic rhinitis).

  • Seborrhoeic dermatitis: scalp, eyebrows, nasolabial folds; think Malassezia.

  • Venous stasis dermatitis: eczematous lower limbs with varicosities and hemosiderin deposition.

Superinfection cluesCrusting, honey-coloured exudate → think Staph aureus.

3) Drug Eruptions

High-yield because stems often drop unmistakable cues.

Key patterns

  • Stevens–Johnson Syndrome / Toxic Epidermal Necrolysis: mucosal involvement, necrolysis, systemic unwellness.

  • DRESS: facial oedema, eosinophilia, onset 2–6 weeks after drug initiation.

  • Fixed drug eruption: recurrent, well-circumscribed lesion at the same site.

  • Photosensitivity drugs: doxycycline, amiodarone, thiazides.

NICE reference for SJS/TEN guidance:https://www.nice.org.uk/guidance/ng182

4) Bullous Disorders

Terminology matters.

Pemphigus vulgaris

  • Flaccid bullae; oral mucosal involvement.

  • Positive Nikolsky sign (skin sloughing with light pressure).

  • Autoantibodies: anti-desmoglein.

Bullous pemphigoid

  • Elderly patients.

  • Tense bullae, minimal mucosal involvement.

  • Autoantibodies: BP180, BP230.

Dermatitis herpetiformis

5) Infections & Infestations

Classic, often repeated themes.

Key recognisers

  • Cellulitis: unilateral, warm, tender; erysipelas has raised demarcation.

  • Tinea corporis: annular lesions with central clearing.

  • Impetigo: honey-coloured crusts.

  • Scabies: burrows in web spaces, nocturnal itching; household contacts similarly affected.


High-Yield Checklist (10 points)

  1. Psoriasis is extensor-predominant; eczema is flexural.

  2. Guttate psoriasis → think recent streptococcal infection.

  3. SJS/TEN = mucosal involvement + systemic unwellness.

  4. DRESS = eosinophilia + facial oedema.

  5. Bullous pemphigoid = tense bullae; pemphigus vulgaris = flaccid bullae.

  6. Dermatitis herpetiformis = coeliac disease.

  7. Impetigo = honey-coloured crusts.

  8. Scabies = burrows + nocturnal pruritus.

  9. Fixed drug eruption = recurs in same location.

  10. Tinea = central clearing and often pruritic.

Abstract illustration of MRCP Part 1 study workflow with laptop, notes, and checklist.

One Simple Reference Table

Condition

Hallmark Feature

Classic Exam Association

Psoriasis

Silvery scale on extensor surfaces

Streptococcal infection, arthritis

Atopic eczema

Flexural dermatitis

Atopy (asthma, allergic rhinitis)

Pemphigus vulgaris

Flaccid bullae + mucosal involvement

Anti-desmoglein antibodies

Bullous pemphigoid

Tense bullae, elderly

BP180/BP230 antibodies

Scabies

Nocturnal pruritus + burrows

Close contacts affected


Practical Example (Mini-Case)

Stem: A 72-year-old man presents with a 3-week history of widespread itchy blisters. Examination shows tense, non-ruptured bullae on the trunk and limbs. Oral mucosa is normal. He takes ramipril and simvastatin.

Most likely diagnosis?

Answer: Bullous pemphigoid.

Reasoning: The age group, tense bullae, and absence of mucosal involvement point squarely toward pemphigoid. Pemphigus vulgaris would involve flaccid lesions and prominent mucosal erosions.


5 Common Pitfalls (and Fixes)

  • Confusing pemphigus with pemphigoid. Fix: Remember PV = flaccid + mucosal.

  • Assuming all rashes with crusting are eczema. Fix: Honey-coloured crusts → think impetigo.

  • Missing DRESS because the time-lag is long. Fix: Onset is 2–6 weeks, not immediate.

  • Over-calling cellulitis vs stasis eczema. Fix: Bilateral red legs in the elderly are usually not cellulitis.

  • Misinterpreting tinea as eczema.Fix: Look for central clearing.


FAQs

1) How much dermatology appears in MRCP Part 1?

A small percentage, but the topics are predictable. Pattern recognition matters more than memorising lists.

2) Do I need to memorise autoantibodies?

Only the classic ones: anti-desmoglein (pemphigus) and BP180/BP230 (pemphigoid). These appear regularly.

3) Are drug rashes commonly tested?

Yes. SJS/TEN, DRESS, and photosensitivity reactions appear frequently due to their systemic implications.

4) Should I know treatments?

MRCP Part 1 rarely asks for detailed regimens but expects recognition of red-flag conditions requiring urgent care (e.g., SJS/TEN).

5) What’s the best way to revise dermatology?

Use a QBank with clinical-style descriptors and practise timed questions. Reinforce themes using official MRCP(UK) curriculum guidance: https://www.mrcpuk.org/mrcpuk-examinations/part-1/about-mrcpuk-part-1


Ready to start?

Strengthen your recall by practising condition-pair questions, reviewing mocks, and revisiting pattern-based images. Try free dermatology MCQs here: https://crackmedicine.com/qbank/Begin a timed mock test: https://crackmedicine.com/mock-tests/Explore our full lecture library: https://crackmedicine.com/lectures/


Sources

 
 
 

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