{"id":36886,"date":"2026-05-30T05:35:48","date_gmt":"2026-05-30T00:05:48","guid":{"rendered":"https:\/\/atsixty.com\/?p=36886"},"modified":"2026-05-30T07:57:49","modified_gmt":"2026-05-30T02:27:49","slug":"dermatology-summative-revision-notes","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/neet-pg\/dermatology-summative-revision-notes\/","title":{"rendered":"Dermatology: Summative Revision Notes"},"content":{"rendered":"\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:ital,wght@0,400;0,600;0,700;1,400;1,600&#038;family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&#038;display=swap\" rel=\"stylesheet\">\n<style>\n\/* Namespaced to #drev01 *\/\n#drev01 *,#drev01 *::before,#drev01 *::after{box-sizing:border-box;margin:0;padding:0}\n#drev01{\n  --teal:#2A7B8C;--teal-dark:#1F5F6B;--teal-pale:#EAF4F6;--teal-mid:#3A9BAC;\n  --ter:#8B3D20;--ter-pale:#FDF0EB;\n  --ink:#2C1810;--ink-mid:#5A3D30;--ink-soft:#9A7060;\n  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#drev01 td,#drev01 th{padding:6px 8px}\n}\n<\/style>\n\n<div id=\"drev01\">\n\n  <div class=\"rv-header\">\n    <div class=\"rv-eyebrow\">Morning Rounds &middot; Dermatology Series<\/div>\n    <div class=\"rv-title\">Dermatology<br><em>Summative Revision Notes<\/em><\/div>\n    <div class=\"rv-subtitle\">Seven topics &middot; NEET-PG and INI-CET &middot; Key facts, tables, and diagrams<\/div>\n    <div class=\"rv-chips\">\n      <span class=\"rv-chip\">Vesiculobullous<\/span>\n      <span class=\"rv-chip\">Papulosquamous<\/span>\n      <span class=\"rv-chip\">Leprosy<\/span>\n      <span class=\"rv-chip\">Infectious<\/span>\n      <span class=\"rv-chip\">Pigmentary<\/span>\n      <span class=\"rv-chip\">Diagnostics<\/span>\n      <span class=\"rv-chip\">Drug Reactions<\/span>\n    <\/div>\n  <\/div>\n\n  <div class=\"rv-body\">\n\n    <div class=\"rv-intro\">\n      <p>These notes summarise the seven Morning Rounds in the Dermatology series. They are written for rapid pre-exam revision, not first-time learning. Each section is self-contained. Read the debrief panels in the quizzes for the full clinical reasoning; use these notes to consolidate what you already know.<\/p>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 1 \u2014 VESICULOBULLOUS DISORDERS\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 01 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Vesiculobullous Disorders<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <!-- SVG 1: Split levels diagram -->\n        <div class=\"rv-figure\">\n          <svg viewBox=\"0 0 680 220\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:680px;display:block;margin:0 auto;font-family:'Source Serif 4',Georgia,serif\">\n            <!-- Background -->\n            <rect width=\"680\" height=\"220\" fill=\"#FFFDF9\" rx=\"6\"\/>\n            <!-- Skin layers -->\n            <!-- Stratum corneum -->\n            <rect x=\"20\" y=\"18\" width=\"640\" height=\"28\" rx=\"3\" fill=\"#E8DDD8\"\/>\n            <text x=\"34\" y=\"36\" fill=\"#5A3D30\" font-size=\"11\" font-weight=\"600\">Stratum Corneum<\/text>\n            <!-- Granular layer -->\n            <rect x=\"20\" y=\"48\" width=\"640\" height=\"20\" rx=\"0\" fill=\"#F0E8E0\"\/>\n            <text x=\"34\" y=\"62\" fill=\"#5A3D30\" font-size=\"10\">Granular Layer<\/text>\n            <!-- Spinous layer -->\n            <rect x=\"20\" y=\"70\" width=\"640\" height=\"28\" rx=\"0\" fill=\"#EAE0D8\"\/>\n            <text x=\"34\" y=\"88\" fill=\"#5A3D30\" font-size=\"10\">Spinous Layer<\/text>\n            <!-- Basal layer -->\n            <rect x=\"20\" y=\"100\" width=\"640\" height=\"20\" rx=\"0\" fill=\"#D8CCC4\"\/>\n            <text x=\"34\" y=\"114\" fill=\"#5A3D30\" font-size=\"10\" font-weight=\"600\">Basal Layer<\/text>\n            <!-- Basement membrane -->\n            <rect x=\"20\" y=\"122\" width=\"640\" height=\"5\" rx=\"0\" fill=\"#8B3D20\" opacity=\"0.4\"\/>\n            <text x=\"34\" y=\"143\" fill=\"#8B3D20\" font-size=\"10\" font-weight=\"600\">Basement Membrane Zone<\/text>\n            <!-- Dermis -->\n            <rect x=\"20\" y=\"150\" width=\"640\" height=\"52\" rx=\"0\" fill=\"#C8D8DC\"\/>\n            <text x=\"34\" y=\"180\" fill=\"#1F5F6B\" font-size=\"11\" font-weight=\"600\">Dermis<\/text>\n\n            <!-- Split level markers -->\n            <!-- Subcorneal (SSSS \/ PF) -->\n            <line x1=\"240\" y1=\"46\" x2=\"240\" y2=\"46\" stroke=\"none\"\/>\n            <path d=\"M 240 48 Q 240 44 260 44 L 400 44 Q 420 44 420 48\" stroke=\"#C0603A\" stroke-width=\"2.5\" fill=\"none\" stroke-dasharray=\"5,3\"\/>\n            <text x=\"310\" y=\"40\" text-anchor=\"middle\" fill=\"#C0603A\" font-size=\"10\" font-weight=\"700\">Subcorneal<\/text>\n            <text x=\"310\" y=\"28\" text-anchor=\"middle\" fill=\"#C0603A\" font-size=\"9\">SSSS &middot; Pemphigus foliaceus<\/text>\n\n            <!-- Suprabasal (PV) -->\n            <path d=\"M 180 100 Q 180 96 200 96 L 310 96 Q 330 96 330 100\" stroke=\"#2A7B8C\" stroke-width=\"2.5\" fill=\"none\" stroke-dasharray=\"5,3\"\/>\n            <text x=\"255\" y=\"92\" text-anchor=\"middle\" fill=\"#2A7B8C\" font-size=\"10\" font-weight=\"700\">Suprabasal<\/text>\n            <text x=\"255\" y=\"80\" text-anchor=\"middle\" fill=\"#2A7B8C\" font-size=\"9\">Pemphigus vulgaris<\/text>\n\n            <!-- Subepidermal (BP \/ DH \/ TEN) -->\n            <path d=\"M 400 122 Q 400 118 420 118 L 560 118 Q 580 118 580 122\" stroke=\"#2D6B47\" stroke-width=\"2.5\" fill=\"none\" stroke-dasharray=\"5,3\"\/>\n            <text x=\"490\" y=\"114\" text-anchor=\"middle\" fill=\"#2D6B47\" font-size=\"10\" font-weight=\"700\">Subepidermal<\/text>\n            <text x=\"490\" y=\"102\" text-anchor=\"middle\" fill=\"#2D6B47\" font-size=\"9\">BP &middot; DH &middot; TEN &middot; EBA<\/text>\n          <\/svg>\n          <div class=\"rv-fig-cap\">Skin split levels in vesiculobullous disorders. The level of separation determines the clinical blister character and the diagnosis.<\/div>\n        <\/div>\n\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr>\n              <th>Disorder<\/th>\n              <th>Split Level<\/th>\n              <th>Acantholysis<\/th>\n              <th>Antigen<\/th>\n              <th>DIF Pattern<\/th>\n              <th>Nikolsky<\/th>\n            <\/tr>\n            <tr>\n              <td><strong>Pemphigus vulgaris<\/strong><\/td>\n              <td>Suprabasal<\/td>\n              <td>Yes<\/td>\n              <td>Dsg3 (&plusmn; Dsg1)<\/td>\n              <td>Intercellular IgG (chicken-wire)<\/td>\n              <td>Positive<\/td>\n            <\/tr>\n            <tr>\n              <td><strong>Pemphigus foliaceus<\/strong><\/td>\n              <td>Subcorneal<\/td>\n              <td>Yes<\/td>\n              <td>Dsg1 only<\/td>\n              <td>Intercellular IgG<\/td>\n              <td>Positive<\/td>\n            <\/tr>\n            <tr>\n              <td><strong>Bullous pemphigoid<\/strong><\/td>\n              <td>Subepidermal<\/td>\n              <td>No<\/td>\n              <td>BP180 + BP230<\/td>\n              <td>Linear IgG + C3 at BMZ<\/td>\n              <td>Negative<\/td>\n            <\/tr>\n            <tr>\n              <td><strong>Dermatitis herpetiformis<\/strong><\/td>\n              <td>Subepidermal<\/td>\n              <td>No<\/td>\n              <td>eTG (TG3)<\/td>\n              <td>Granular IgA at papillary tips<\/td>\n              <td>Negative<\/td>\n            <\/tr>\n            <tr>\n              <td><strong>SSSS<\/strong><\/td>\n              <td>Subcorneal<\/td>\n              <td>Yes<\/td>\n              <td>Dsg1 (exfoliatin)<\/td>\n              <td>N\/A (not autoimmune)<\/td>\n              <td>Positive<\/td>\n            <\/tr>\n            <tr>\n              <td><strong>TEN<\/strong><\/td>\n              <td>Subepidermal<\/td>\n              <td>No<\/td>\n              <td>Drug-induced<\/td>\n              <td>N\/A<\/td>\n              <td>Positive<\/td>\n            <\/tr>\n          <\/table>\n        <\/div>\n\n        <div class=\"rv-sub\">Key rules to remember<\/div>\n        <p><strong>Desmoglein compensation theory:<\/strong> Dsg3 is abundant in mucosa; Dsg1 dominates in superficial skin. Anti-Dsg1 alone (PF, SSSS) spares mucosa because Dsg3 compensates. Anti-Dsg3 (PV) always involves mucosa.<\/p>\n        <p><strong>SSSS vs TEN:<\/strong> SSSS = subcorneal, no mucosa, no scarring, sterile blister fluid, children. TEN = full-thickness necrosis, mucosa invariably involved, significant mortality (SCORTEN). Frozen section of blister roof distinguishes them emergently.<\/p>\n        <p><strong>Dermatitis herpetiformis:<\/strong> associated with coeliac disease in virtually 100%. Gluten-free diet is definitive treatment. Dapsone for rapid symptom control. Check G6PD before dapsone.<\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 2 \u2014 PAPULOSQUAMOUS & ECZEMAS\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 02 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Papulosquamous Diseases &amp; Eczemas<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <div class=\"rv-sub\">Psoriasis<\/div>\n        <p><strong>Auspitz sign:<\/strong> stepwise scraping reveals candle grease &rarr; Bulkley membrane &rarr; pinpoint bleeding (dilated papillary capillaries). <strong>Histology:<\/strong> parakeratosis, Munro microabscesses, suprapapillary thinning. <strong>Nail changes<\/strong> in frequency order: pitting &gt; onycholysis &gt; subungual hyperkeratosis &gt; oil-drop sign. Koebner positive.<\/p>\n\n        <div class=\"rv-sub\">Lichen Planus<\/div>\n        <p><strong>4 Ps:<\/strong> Pruritic, Purple, Polygonal, Papules. <strong>Wickham striae<\/strong> = focal hypergranulosis. Histology: saw-tooth rete ridges, band-like lymphocytic infiltrate at DEJ, Civatte bodies, hypergranulosis. Oral LP erosive type = potentially premalignant. Associated with <strong>hepatitis C<\/strong>. Koebner positive. Heals with post-inflammatory hyperpigmentation.<\/p>\n\n        <div class=\"rv-sub\">Pityriasis Rosea<\/div>\n        <p><strong>Herald patch<\/strong> precedes generalised eruption by 1&ndash;2 weeks. Secondary lesions follow Langer lines &rarr; <strong>Christmas tree pattern<\/strong> on back. Collarette scaling from inner edge. Spares face, palms, soles. Self-limiting 6&ndash;8 weeks. HHV-6\/7 association. <strong>Trap:<\/strong> secondary syphilis mimics PR but involves palms and soles &mdash; always check VDRL in sexually active adults.<\/p>\n\n        <div class=\"rv-sub\">Atopic Dermatitis<\/div>\n        <p><strong>Age-based distribution:<\/strong> infantile (&lt;2 yr) = face + extensors; childhood (2&ndash;12 yr) = <strong>flexures<\/strong> (antecubital, popliteal); adult = flexural + hand eczema. Elevated IgE. <strong>Atopic triad:<\/strong> AD + asthma + allergic rhinitis. Dennie-Morgan lines; Hertoghe sign. Filaggrin (FLG) gene mutation = barrier defect. Treatment: emollients first; topical calcineurin inhibitors (tacrolimus) safe on face.<\/p>\n\n        <div class=\"rv-sub\">Contact Dermatitis<\/div>\n        <p><strong>Allergic CD:<\/strong> Type IV hypersensitivity, requires sensitisation (10&ndash;14 days minimum), patch test positive, can spread beyond contact area. Most common allergen: <strong>nickel<\/strong>. <strong>Irritant CD:<\/strong> non-immunological, first exposure, strictly confined, patch test negative. India-specific: <strong>Parthenium dermatitis<\/strong> (Congress grass, airborne), <strong>bindi dermatitis<\/strong> (PTBP resin).<\/p>\n\n        <p><span class=\"rv-pill\">Koebner: Psoriasis, LP, Vitiligo<\/span> <span class=\"rv-pill\">Dapsone: check G6PD always<\/span> <span class=\"rv-pill\">RF does NOT follow skin strep<\/span><\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 3 \u2014 LEPROSY\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 03 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Leprosy &mdash; Hansen&rsquo;s Disease<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <!-- SVG 2: Ridley-Jopling spectrum -->\n        <div class=\"rv-figure\">\n          <svg viewBox=\"0 0 660 160\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:660px;display:block;margin:0 auto;font-family:'Source Serif 4',Georgia,serif\">\n            <rect width=\"660\" height=\"160\" fill=\"#FFFDF9\" rx=\"6\"\/>\n            <!-- Spectrum bar gradient -->\n            <defs>\n              <linearGradient id=\"specGrad\" x1=\"0%\" y1=\"0%\" x2=\"100%\" y2=\"0%\">\n                <stop offset=\"0%\" style=\"stop-color:#2A7B8C;stop-opacity:1\"\/>\n                <stop offset=\"50%\" style=\"stop-color:#8B6A3A;stop-opacity:1\"\/>\n                <stop offset=\"100%\" style=\"stop-color:#8B3D20;stop-opacity:1\"\/>\n              <\/linearGradient>\n            <\/defs>\n            <rect x=\"30\" y=\"60\" width=\"600\" height=\"24\" rx=\"12\" fill=\"url(#specGrad)\"\/>\n            <!-- Type markers -->\n            <line x1=\"30\"  y1=\"55\" x2=\"30\"  y2=\"90\" stroke=\"#2A7B8C\" stroke-width=\"2\"\/>\n            <line x1=\"180\" y1=\"55\" x2=\"180\" y2=\"90\" stroke=\"#5A8A6A\" stroke-width=\"1.5\" stroke-dasharray=\"4,2\"\/>\n            <line x1=\"330\" y1=\"55\" x2=\"330\" y2=\"90\" stroke=\"#8B6A3A\" stroke-width=\"1.5\" stroke-dasharray=\"4,2\"\/>\n            <line x1=\"480\" y1=\"55\" x2=\"480\" y2=\"90\" stroke=\"#A05030\" stroke-width=\"1.5\" stroke-dasharray=\"4,2\"\/>\n            <line x1=\"630\" y1=\"55\" x2=\"630\" y2=\"90\" stroke=\"#8B3D20\" stroke-width=\"2\"\/>\n            <!-- Labels top -->\n            <text x=\"30\"  y=\"50\" text-anchor=\"middle\" fill=\"#2A7B8C\" font-size=\"12\" font-weight=\"700\">TT<\/text>\n            <text x=\"180\" y=\"50\" text-anchor=\"middle\" fill=\"#5A8A6A\" font-size=\"12\" font-weight=\"700\">BT<\/text>\n            <text x=\"330\" y=\"50\" text-anchor=\"middle\" fill=\"#8B6A3A\" font-size=\"12\" font-weight=\"700\">BB<\/text>\n            <text x=\"480\" y=\"50\" text-anchor=\"middle\" fill=\"#A05030\" font-size=\"12\" font-weight=\"700\">BL<\/text>\n            <text x=\"630\" y=\"50\" text-anchor=\"middle\" fill=\"#8B3D20\" font-size=\"12\" font-weight=\"700\">LL<\/text>\n            <!-- CMI row -->\n            <text x=\"340\" y=\"108\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9.5\" font-weight=\"600\">CELL-MEDIATED IMMUNITY<\/text>\n            <text x=\"40\"  y=\"120\" fill=\"#2A7B8C\" font-size=\"9\">Strong<\/text>\n            <text x=\"585\" y=\"120\" fill=\"#8B3D20\" font-size=\"9\">Absent<\/text>\n            <!-- Bacilli row -->\n            <text x=\"340\" y=\"135\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9.5\" font-weight=\"600\">BACILLARY LOAD<\/text>\n            <text x=\"40\"  y=\"147\" fill=\"#2A7B8C\" font-size=\"9\">Low (BI 0)<\/text>\n            <text x=\"555\" y=\"147\" fill=\"#8B3D20\" font-size=\"9\">High (BI 6+)<\/text>\n            <!-- Lepromin -->\n            <text x=\"40\"  y=\"158\" fill=\"#2A7B8C\" font-size=\"9\">Lepromin +ve<\/text>\n            <text x=\"545\" y=\"158\" fill=\"#8B3D20\" font-size=\"9\">Lepromin &minus;ve<\/text>\n          <\/svg>\n          <div class=\"rv-fig-cap\">Ridley-Jopling spectrum of leprosy. Borderline forms (BT, BB, BL) are immunologically unstable and prone to lepra reactions.<\/div>\n        <\/div>\n\n        <div class=\"rv-sub\">Nerve involvement \u2014 order of frequency<\/div>\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr><th>Nerve<\/th><th>Deformity \/ Deficit<\/th><\/tr>\n            <tr><td><strong>Ulnar<\/strong> (most common overall)<\/td><td>Claw hand \u2014 ring &amp; little fingers; medial 1.5 finger sensory loss<\/td><\/tr>\n            <tr><td><strong>Common peroneal<\/strong><\/td><td>Foot drop; steppage gait<\/td><\/tr>\n            <tr><td><strong>Posterior tibial<\/strong><\/td><td>Plantar anaesthesia; trophic ulcers<\/td><\/tr>\n            <tr><td><strong>Radial cutaneous<\/strong><\/td><td>Sensory loss, dorsum of hand<\/td><\/tr>\n            <tr><td><strong>Facial<\/strong><\/td><td>Lagophthalmos &rarr; exposure keratitis &rarr; <strong>blindness<\/strong><\/td><\/tr>\n            <tr><td><strong>Greater auricular<\/strong><\/td><td>Thickened, visible nerve at neck<\/td><\/tr>\n          <\/table>\n        <\/div>\n\n        <div class=\"rv-sub\">Lepra reactions<\/div>\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr><th><\/th><th>Type 1 (Reversal)<\/th><th>Type 2 (ENL)<\/th><\/tr>\n            <tr><td><strong>Leprosy types<\/strong><\/td><td>BT, BB, BL only<\/td><td>LL and BL only<\/td><\/tr>\n            <tr><td><strong>Hypersensitivity<\/strong><\/td><td>Type IV (cell-mediated)<\/td><td>Type III (immune complex)<\/td><\/tr>\n            <tr><td><strong>Skin<\/strong><\/td><td>Existing lesions inflamed\/oedematous<\/td><td>New tender erythematous nodules<\/td><\/tr>\n            <tr><td><strong>Nerve<\/strong><\/td><td>Sudden nerve function impairment<\/td><td>Less prominent<\/td><\/tr>\n            <tr><td><strong>Systemic<\/strong><\/td><td>Absent<\/td><td>Fever, iritis, orchitis, nephritis<\/td><\/tr>\n            <tr><td><strong>Treatment<\/strong><\/td><td>Prednisolone<\/td><td>Thalidomide (DOC); steroids if contraindicated<\/td><\/tr>\n          <\/table>\n        <\/div>\n\n        <div class=\"rv-sub\">MDT regimen<\/div>\n        <p><strong>PB (&le;5 lesions):<\/strong> Rifampicin 600 mg monthly + Dapsone 100 mg daily &mdash; 6 months. <strong>MB (&gt;5 lesions):<\/strong> Rifampicin 600 mg monthly + Clofazimine 300 mg monthly and 50 mg daily + Dapsone 100 mg daily &mdash; 12 months. <strong>Rifampicin = only bactericidal drug.<\/strong> Clofazimine: reddish-brown pigmentation + ichthyosis. MDT is continued through reactions.<\/p>\n        <p><span class=\"rv-pill\">Pure neuritic leprosy: more common in India<\/span> <span class=\"rv-pill\">Lepromin = NOT diagnostic; tests CMI only<\/span> <span class=\"rv-pill\">Elimination &ne; eradication<\/span><\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 4 \u2014 INFECTIOUS DERMATOSES\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 04 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Infectious Dermatoses<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <div class=\"rv-sub\">Scabies<\/div>\n        <p>Pathognomonic lesion: <strong>burrow<\/strong> (linear track of female <em>Sarcoptes scabiei<\/em> in stratum corneum). Nocturnal pruritus. Treatment: <strong>permethrin 5% cream<\/strong>, neck to toes, 8&ndash;12 hours, repeat at 1 week. Treat all contacts simultaneously. <strong>Norwegian scabies:<\/strong> immunocompromised, millions of mites, minimal itch, highly contagious &mdash; oral ivermectin required. Post-scabietic nodules = hypersensitivity, not re-infection.<\/p>\n\n        <div class=\"rv-sub\">Tinea Versicolor<\/div>\n        <p>Cause: <strong>Malassezia furfur.<\/strong> KOH: <strong>spaghetti and meatballs<\/strong> (short hyphae + round spores). Wood lamp: <strong>golden-yellow.<\/strong> Hypopigmentation due to azelaic acid inhibiting tyrosinase. Pigment change persists months after treatment &mdash; warn patients.<\/p>\n\n        <div class=\"rv-sub\">Impetigo<\/div>\n        <p><strong>Bullous:<\/strong> Staph aureus phage group II, localised exfoliatin cleaving Dsg1, flaccid bullae, sterile. <strong>Non-bullous:<\/strong> Staph or Strep pyogenes, honey-coloured crusts. <strong>Critical distinction:<\/strong> non-bullous impetigo (Strep) can cause <strong>PSGN<\/strong>. Skin strep does <em>NOT<\/em> cause rheumatic fever. Treatment: topical mupirocin for localised disease.<\/p>\n\n        <div class=\"rv-sub\">Herpes Zoster<\/div>\n        <p><strong>Ramsay Hunt syndrome:<\/strong> VZV in geniculate ganglion &rarr; ear vesicles + ipsilateral facial palsy + sensorineural hearing loss. Worse prognosis than Bell palsy. <strong>Hutchinson sign:<\/strong> vesicles on nasal tip (nasociliary branch, V1) &rarr; risk of ophthalmic zoster and corneal damage &rarr; urgent ophthalmology. PHN = most common complication; early antivirals reduce risk.<\/p>\n\n        <div class=\"rv-sub\">Tinea Capitis<\/div>\n        <p><strong>Endothrix<\/strong> (<em>T. tonsurans<\/em>): spores inside shaft, black dot, <strong>no Wood lamp fluorescence.<\/strong> Most common in India and USA. <strong>Ectothrix<\/strong> (<em>Microsporum<\/em>): spores outside shaft, <strong>green fluorescence.<\/strong> Oral antifungal mandatory (topical cannot penetrate shaft). Kerion: boggy mass, do not incise. Favus (<em>T. schoenleinii<\/em>): scutula, mousy odour, <strong>permanent scarring alopecia.<\/strong><\/p>\n\n        <p><span class=\"rv-pill\">Erythrasma: coral-red Wood lamp<\/span> <span class=\"rv-pill teal\">Corynebacterium minutissimum &rarr; porphyrins<\/span><\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 5 \u2014 PIGMENTARY DISORDERS\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 05 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Pigmentary Disorders<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <div class=\"rv-sub\">Vitiligo vs Albinism \u2014 the critical distinction<\/div>\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr><th><\/th><th>Vitiligo<\/th><th>Albinism (OCA1)<\/th><\/tr>\n            <tr><td><strong>Melanocytes<\/strong><\/td><td>Absent (destroyed)<\/td><td>Present, non-functional<\/td><\/tr>\n            <tr><td><strong>Mechanism<\/strong><\/td><td>Autoimmune destruction<\/td><td>Tyrosinase deficiency<\/td><\/tr>\n            <tr><td><strong>Wood lamp<\/strong><\/td><td>Chalk-white fluorescence<\/td><td>Not useful<\/td><\/tr>\n            <tr><td><strong>Eye signs<\/strong><\/td><td>None<\/td><td>Nystagmus, photophobia, reduced VA<\/td><\/tr>\n            <tr><td><strong>Main risk<\/strong><\/td><td>Autoimmune associations<\/td><td>SCC in sun-exposed skin<\/td><\/tr>\n            <tr><td><strong>Treatment<\/strong><\/td><td>NB-UVB; topical tacrolimus<\/td><td>Photoprotection; skin surveillance<\/td><\/tr>\n          <\/table>\n        <\/div>\n\n        <p><strong>Leukotrichia<\/strong> (white hairs in vitiligo) = poor prognosis for repigmentation. Repigmentation begins <em>perifollicularly.<\/em> Vitiligo autoimmune associations: thyroid, DM type 1, Addison, pernicious anaemia, alopecia areata.<\/p>\n\n        <div class=\"rv-sub\">Melasma<\/div>\n        <p>Epidermal type: Wood lamp <strong>accentuates<\/strong> (better treatment response). Dermal type: <strong>not accentuated<\/strong> (harder to treat). Kligman formula (hydroquinone + tretinoin + mild steroid) = most effective single regimen. Prolonged hydroquinone &rarr; <strong>exogenous ochronosis<\/strong>. Sunscreen mandatory and lifelong. Oral tranexamic acid for resistant cases.<\/p>\n\n        <div class=\"rv-sub\">Freckles vs Lentigines<\/div>\n        <p><strong>Freckles (ephelides):<\/strong> normal melanocyte count, increased melanin per cell, fade in winter, childhood onset, MC1R gene. <strong>Lentigines:<\/strong> increased melanocyte count, do not fade in winter. <strong>Lentigo maligna:<\/strong> slow-growing irregular macule on sun-damaged skin = premalignant (<em>in situ<\/em> lentigo maligna melanoma).<\/p>\n\n        <div class=\"rv-sub\">NF-1 and Caf&eacute;-au-lait Spots<\/div>\n        <p>NF-1: &ge;6 CALMs (&gt;15 mm adults), <strong>Lisch nodules<\/strong> (iris hamartomas, pathognomonic), axillary freckling (Crowe sign). Chr 17, neurofibromin. CALMs: smooth <strong>coast of California<\/strong> borders. <strong>McCune-Albright:<\/strong> irregular <strong>coast of Maine<\/strong> borders + polyostotic fibrous dysplasia + precocious puberty. NF-2: chr 22, bilateral acoustic neuromas, fewer CALMs, no Lisch nodules.<\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 6 \u2014 HISTOPATHOLOGY & DIAGNOSTICS\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 06 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Histopathology &amp; Diagnostic Tests<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <div class=\"rv-sub\">Tzanck smear<\/div>\n        <p>Scrape base of fresh vesicle; stain Giemsa. <strong>Positive in:<\/strong> HSV (multinucleate giant cells with nuclear moulding), VZV (same), Pemphigus vulgaris (acantholytic cells, no nuclear moulding). <strong>Negative in:<\/strong> bullous pemphigoid, DH, impetigo. Does not distinguish HSV-1 from HSV-2 or from VZV.<\/p>\n\n        <div class=\"rv-sub\">Wood lamp fluorescence \u2014 complete table<\/div>\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr><th>Condition<\/th><th>Fluorescence Colour<\/th><th>Organism \/ Mechanism<\/th><\/tr>\n            <tr><td><strong>Erythrasma<\/strong><\/td><td>Coral-red<\/td><td><em>Corynebacterium minutissimum<\/em> &mdash; porphyrins<\/td><\/tr>\n            <tr><td><strong>Tinea versicolor<\/strong><\/td><td>Golden-yellow<\/td><td><em>Malassezia furfur<\/em><\/td><\/tr>\n            <tr><td><strong>Microsporum tinea capitis<\/strong><\/td><td>Bright green<\/td><td>Ectothrix<\/td><\/tr>\n            <tr><td><strong>Pseudomonas infection<\/strong><\/td><td>Yellow-green<\/td><td>Pyocyanin<\/td><\/tr>\n            <tr><td><strong>Vitiligo<\/strong><\/td><td>Chalk-white (enhanced)<\/td><td>Absent melanin<\/td><\/tr>\n            <tr><td><strong>Tuberous sclerosis<\/strong> (ash-leaf)<\/td><td>White (enhanced)<\/td><td>Hypomelanosis<\/td><\/tr>\n            <tr><td><strong>Trichophyton tinea capitis<\/strong><\/td><td>No fluorescence<\/td><td>Endothrix<\/td><\/tr>\n            <tr><td><strong>Dermal melasma<\/strong><\/td><td>Not accentuated<\/td><td>Deep pigment<\/td><\/tr>\n          <\/table>\n        <\/div>\n\n        <div class=\"rv-sub\">Patch test vs Prick test<\/div>\n        <p><strong>Patch test:<\/strong> Type IV CMI, 48 h occlusion + read at 48 and 96 h, gold standard for ACD, most common positive allergen = nickel. <strong>Prick test:<\/strong> Type I IgE-mediated, read at 15&ndash;20 min, for atopy\/food allergy. Patch test: not during systemic steroids; not on active eczema.<\/p>\n\n        <div class=\"rv-sub\">Stains summary<\/div>\n        <p><strong>PAS:<\/strong> fungi in tissue sections (magenta &mdash; cell wall polysaccharides). <strong>KOH mount:<\/strong> dissolves keratin, direct microscopy of hyphae\/spores. <strong>GMS (Grocott):<\/strong> fungi in tissue (black, more sensitive than PAS). <strong>India ink:<\/strong> <em>Cryptococcus<\/em> in CSF (clear capsular halo). <strong>ZN stain:<\/strong> acid-fast mycobacteria.<\/p>\n\n        <div class=\"rv-sub\">Dermoscopy key patterns<\/div>\n        <p><strong>Melanoma:<\/strong> irregular pigment network, blue-white veil, regression structures. <strong>BCC:<\/strong> arborising telangiectasia, blue-grey ovoid nests, leaf-like areas. <strong>Seborrhoeic keratosis:<\/strong> comedone-like openings, milia-like cysts, brain-like fissures. <strong>Scabies:<\/strong> jet with contrail sign (mite body at burrow tip). <strong>Dermatofibroma:<\/strong> central white patch + peripheral pigment network.<\/p>\n      <\/div>\n    <\/div>\n\n    <!-- \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\n         SECTION 7 \u2014 DRUG REACTIONS\n    \u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550\u2550 -->\n    <div class=\"rv-section\">\n      <div class=\"rv-sec-head\">\n        <div class=\"rv-sec-num\">Topic 07 &middot; Dermatology<\/div>\n        <div class=\"rv-sec-title\">Drug Reactions &amp; Cutaneous Side Effects<\/div>\n      <\/div>\n      <div class=\"rv-sec-body\">\n\n        <div class=\"rv-sub\">Fixed Drug Eruption<\/div>\n        <p>Recurs at <strong>exact same site<\/strong> on re-exposure. Violaceous plaque &rarr; resolves with residual hyperpigmentation. Common sites: genitalia, lips, perianal. <strong>Most common cause: cotrimoxazole.<\/strong> Others: NSAIDs, metronidazole, tetracyclines, paracetamol. Mechanism: CD8+ T cells resident at prior FDE sites.<\/p>\n\n        <div class=\"rv-sub\">DRESS Syndrome<\/div>\n        <p>Onset <strong>2&ndash;8 weeks<\/strong> after drug start (long latency is the clue). Morbilliform rash + facial oedema + fever + lymphadenopathy + <strong>eosinophilia<\/strong> + organ involvement (liver most common) + HHV-6 reactivation. <strong>Aromatic AEDs cross-react<\/strong>: phenytoin, carbamazepine, phenobarbitone &mdash; never substitute one for another. Other causes: allopurinol, sulphonamides, dapsone, minocycline. Mortality ~10%.<\/p>\n\n        <div class=\"rv-sub\">SJS and TEN<\/div>\n        <p>SJS &lt;10% BSA; SJS\/TEN overlap 10&ndash;30%; TEN &gt;30% BSA. Both require mucosal involvement. <strong>Most common cause worldwide: allopurinol<\/strong> (HLA-B*58:01 in Han Chinese\/Thai). Other causes: sulphonamides, aromatic AEDs, oxicam NSAIDs, nevirapine. <strong>Stop the drug immediately<\/strong> = single most important step. SCORTEN predicts mortality. Management: ICU\/burns unit, cyclosporine or IVIG as adjuncts.<\/p>\n\n        <div class=\"rv-sub\">Photosensitivity<\/div>\n        <p><strong>Phototoxic:<\/strong> non-immunological, first exposure, sun-exposed only, any person. Drugs: doxycycline, fluoroquinolones, amiodarone, thiazides, NSAIDs. <strong>Photoallergic:<\/strong> Type IV, sensitisation required, can spread beyond sun-exposed areas. Drugs: sulphonamides, phenothiazines, sunscreens (PABA), griseofulvin.<\/p>\n\n        <div class=\"rv-sub\">Drug-induced pigmentation \u2014 complete table<\/div>\n        <div class=\"rv-table-wrap\">\n          <table>\n            <tr><th>Drug<\/th><th>Pigmentation<\/th><th>Extra<\/th><\/tr>\n            <tr><td><strong>Amiodarone<\/strong><\/td><td>Slate-grey, sun-exposed<\/td><td>Phototoxic + lipofuscin; corneal deposits; thyroid dysfunction<\/td><\/tr>\n            <tr><td><strong>Minocycline<\/strong><\/td><td>Blue-grey (skin, teeth, sclerae, bone)<\/td><td>Can be permanent<\/td><\/tr>\n            <tr><td><strong>Clofazimine<\/strong><\/td><td>Reddish-brown, diffuse<\/td><td>Ichthyosis; reversible slowly<\/td><\/tr>\n            <tr><td><strong>Bleomycin<\/strong><\/td><td>Flagellate hyperpigmentation (linear streaks)<\/td><td>Along scratch lines; post-chemotherapy<\/td><\/tr>\n            <tr><td><strong>Busulfan<\/strong><\/td><td>Diffuse Addisonian-like<\/td><td>MSH-like effect<\/td><\/tr>\n            <tr><td><strong>Hydroxychloroquine<\/strong><\/td><td>Blue-grey<\/td><td>Corneal deposits + retinopathy (monitor annually)<\/td><\/tr>\n            <tr><td><strong>Silver (argyria)<\/strong><\/td><td>Permanent grey-blue, sun-exposed<\/td><td>No treatment available<\/td><\/tr>\n            <tr><td><strong>Gold (chrysiasis)<\/strong><\/td><td>Blue-grey, sun-exposed<\/td><td>Permanent<\/td><\/tr>\n          <\/table>\n        <\/div>\n\n        <!-- SVG 3: Desmoglein compensation -->\n        <div class=\"rv-figure\" style=\"margin-top:18px\">\n          <svg viewBox=\"0 0 660 200\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" style=\"width:100%;max-width:660px;display:block;margin:0 auto;font-family:'Source Serif 4',Georgia,serif\">\n            <rect width=\"660\" height=\"200\" fill=\"#FFFDF9\" rx=\"6\"\/>\n            <!-- Title -->\n            <text x=\"330\" y=\"20\" text-anchor=\"middle\" fill=\"#2C1810\" font-size=\"12\" font-weight=\"700\">Desmoglein Compensation Theory<\/text>\n\n            <!-- Column headers -->\n            <rect x=\"30\"  y=\"28\" width=\"190\" height=\"22\" rx=\"4\" fill=\"#2A7B8C\"\/>\n            <rect x=\"240\" y=\"28\" width=\"190\" height=\"22\" rx=\"4\" fill=\"#8B3D20\"\/>\n            <rect x=\"450\" y=\"28\" width=\"190\" height=\"22\" rx=\"4\" fill=\"#2D6B47\"\/>\n            <text x=\"125\" y=\"43\" text-anchor=\"middle\" fill=\"#FFFDF9\" font-size=\"11\" font-weight=\"700\">Pemphigus Vulgaris<\/text>\n            <text x=\"335\" y=\"43\" text-anchor=\"middle\" fill=\"#FFFDF9\" font-size=\"11\" font-weight=\"700\">Pemphigus Foliaceus \/ SSSS<\/text>\n            <text x=\"545\" y=\"43\" text-anchor=\"middle\" fill=\"#FFFDF9\" font-size=\"11\" font-weight=\"700\">Bullous Pemphigoid<\/text>\n\n            <!-- Antibody row -->\n            <text x=\"125\" y=\"72\" text-anchor=\"middle\" fill=\"#2A7B8C\" font-size=\"10\" font-weight=\"700\">Anti-Dsg3 (&plusmn; Dsg1)<\/text>\n            <text x=\"335\" y=\"72\" text-anchor=\"middle\" fill=\"#8B3D20\" font-size=\"10\" font-weight=\"700\">Anti-Dsg1 only<\/text>\n            <text x=\"545\" y=\"72\" text-anchor=\"middle\" fill=\"#2D6B47\" font-size=\"10\" font-weight=\"700\">Anti-BP180\/BP230<\/text>\n\n            <!-- Mucosa row -->\n            <rect x=\"30\"  y=\"82\" width=\"190\" height=\"34\" rx=\"4\" fill=\"#EAF4F6\"\/>\n            <rect x=\"240\" y=\"82\" width=\"190\" height=\"34\" rx=\"4\" fill=\"#FDF0EB\"\/>\n            <rect x=\"450\" y=\"82\" width=\"190\" height=\"34\" rx=\"4\" fill=\"#EAF6EF\"\/>\n            <text x=\"125\" y=\"96\" text-anchor=\"middle\" fill=\"#2C1810\" font-size=\"10\">Mucosa<\/text>\n            <text x=\"125\" y=\"110\" text-anchor=\"middle\" fill=\"#B83232\" font-size=\"11\" font-weight=\"700\">INVOLVED<\/text>\n            <text x=\"335\" y=\"96\" text-anchor=\"middle\" fill=\"#2C1810\" font-size=\"10\">Mucosa<\/text>\n            <text x=\"335\" y=\"110\" text-anchor=\"middle\" fill=\"#2D6B47\" font-size=\"11\" font-weight=\"700\">SPARED<\/text>\n            <text x=\"545\" y=\"96\" text-anchor=\"middle\" fill=\"#2C1810\" font-size=\"10\">Mucosa<\/text>\n            <text x=\"545\" y=\"110\" text-anchor=\"middle\" fill=\"#2D6B47\" font-size=\"11\" font-weight=\"700\">SPARED<\/text>\n\n            <!-- Explanation row -->\n            <text x=\"125\" y=\"138\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">Dsg1 cannot compensate<\/text>\n            <text x=\"125\" y=\"150\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">for Dsg3 loss in mucosa<\/text>\n            <text x=\"335\" y=\"138\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">Dsg3 compensates for<\/text>\n            <text x=\"335\" y=\"150\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">Dsg1 loss in mucosa<\/text>\n            <text x=\"545\" y=\"138\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">Split is subepidermal;<\/text>\n            <text x=\"545\" y=\"150\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">no desmosomal target<\/text>\n\n            <!-- Skin row -->\n            <text x=\"125\" y=\"176\" text-anchor=\"middle\" fill=\"#B83232\" font-size=\"10\" font-weight=\"700\">Skin: INVOLVED<\/text>\n            <text x=\"335\" y=\"176\" text-anchor=\"middle\" fill=\"#B83232\" font-size=\"10\" font-weight=\"700\">Skin: INVOLVED<\/text>\n            <text x=\"545\" y=\"176\" text-anchor=\"middle\" fill=\"#B83232\" font-size=\"10\" font-weight=\"700\">Skin: INVOLVED<\/text>\n            <text x=\"125\" y=\"190\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">(suprabasal split)<\/text>\n            <text x=\"335\" y=\"190\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">(subcorneal split)<\/text>\n            <text x=\"545\" y=\"190\" text-anchor=\"middle\" fill=\"#5A3D30\" font-size=\"9\">(subepidermal split)<\/text>\n          <\/svg>\n          <div class=\"rv-fig-cap\">Desmoglein compensation explains mucosal involvement patterns across pemphigus subtypes and SSSS. This single diagram resolves the most common confusion in vesiculobullous questions.<\/div>\n        <\/div>\n\n        <p><span class=\"rv-pill\">FDE: same site = pathognomonic<\/span> <span class=\"rv-pill\">DRESS: 2-8 weeks, eosinophilia<\/span> <span class=\"rv-pill\">TEN: stop drug first<\/span> <span class=\"rv-pill teal\">Allopurinol + HLA-B*58:01<\/span><\/p>\n\n      <\/div>\n    <\/div>\n\n    <!-- Footer note -->\n    <div style=\"margin-top:32px;text-align:center;font-size:0.80rem;color:#9A7060;font-style:italic;line-height:1.6\">\n      Dermatology Summative Revision &middot; atsixty.com &middot; Morning Rounds Series<br>\n      For clinical reasoning practice, return to the seven Morning Rounds quizzes linked in the series index.\n    <\/div>\n\n  <\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Morning Rounds &middot; Dermatology Series DermatologySummative Revision Notes Seven topics &middot; NEET-PG and INI-CET &middot; Key facts, tables, and diagrams Vesiculobullous Papulosquamous Leprosy Infectious Pigmentary Diagnostics Drug Reactions These notes summarise the seven Morning Rounds in the Dermatology series. They are written for rapid pre-exam revision, not first-time learning. Each section is self-contained. Read the&hellip;&nbsp;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[70,68,74,24],"tags":[],"class_list":["post-36886","post","type-post","status-publish","format-standard","hentry","category-clinical","category-dermatology","category-morning-rounds","category-neet-pg"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Dermatology: Summative Revision Notes - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/neet-pg\/dermatology-summative-revision-notes\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dermatology: Summative Revision Notes - atsixty\" \/>\n<meta property=\"og:description\" content=\"Morning Rounds &middot; Dermatology Series DermatologySummative Revision Notes Seven topics &middot; NEET-PG and INI-CET &middot; Key facts, tables, and diagrams Vesiculobullous Papulosquamous Leprosy Infectious Pigmentary Diagnostics Drug Reactions These notes summarise the seven Morning Rounds in the Dermatology series. 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Dermatology Series DermatologySummative Revision Notes Seven topics &middot; NEET-PG and INI-CET &middot; Key facts, tables, and diagrams Vesiculobullous Papulosquamous Leprosy Infectious Pigmentary Diagnostics Drug Reactions These notes summarise the seven Morning Rounds in the Dermatology series. They are written for rapid pre-exam revision, not first-time learning. Each section is self-contained. 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