How to Prepare Dermatology for FMGE 2026: High-Yield Topics and Strategy

By Dr. Utsav Bhattacherjee, MBBS, MBA · 26 August 2026 · 9 min read

FMGE Dermatology high yield topics

• Primary and secondary skin lesion morphology — the precise vocabulary that most other dermatology questions build on.
• Psoriasis vs eczema — distinguishing two of the most commonly tested inflammatory skin conditions.
• Severe drug reactions — the Stevens-Johnson syndrome and toxic epidermal necrolysis spectrum.
• Fungal infections — classification by site and organism.
• Scabies and other infestations — recognition and the classic distribution pattern.
• Skin cancers — basal cell carcinoma, squamous cell carcinoma and melanoma, distinguished by appearance and behaviour.

Primary and secondary lesions: the vocabulary everything else builds on

Getting these definitions precise matters because a question describing a lesion is really asking you to identify it correctly first, before the actual diagnosis becomes apparent — misreading papule as vesicle, for instance, can point you toward an entirely wrong differential.

Psoriasis vs eczema: the distinctions that matter

Both present with itchy, scaly skin, but the exam rewards knowing what separates them. Psoriasis classically presents with well-demarcated, silvery-scaled plaques, often on extensor surfaces (elbows, knees) and the scalp, and can be associated with nail changes (pitting) and psoriatic arthritis. The Auspitz sign — pinpoint bleeding when a scale is removed — is a classic supportive finding. Eczema (atopic dermatitis) classically presents with ill-defined, often weeping or crusted patches on flexor surfaces (the antecubital and popliteal fossae), frequently in patients with a personal or family history of atopy (asthma, allergic rhinitis). The distribution pattern — extensor in psoriasis, flexor in eczema — is one of the fastest ways to distinguish them in a described or pictured case.

The Stevens-Johnson syndrome to TEN spectrum

This is a single spectrum of severe, drug-related mucocutaneous reactions, differentiated by the extent of body surface area involved. Stevens-Johnson syndrome involves less than 10% of body surface area, presenting with target-like or atypical lesions, mucosal involvement (oral, ocular, genital) and systemic symptoms. Toxic epidermal necrolysis (TEN) involves more than 30% of body surface area, representing the more severe end of the same underlying process, with widespread skin detachment resembling a burn injury. The 10-30% range is classified as SJS/TEN overlap. Common triggering drugs include certain anticonvulsants, sulfonamide antibiotics and allopurinol — knowing this drug association matters clinically, since recognising the reaction early and stopping the causative drug is critical to limiting progression. Nikolsky sign — the epidermis shearing off with lateral pressure on apparently normal skin — is positive across this spectrum, reflecting the same underlying mechanism of epidermal detachment seen in pemphigus vulgaris.

Fungal infections: classification by depth and site

Dermatophyte infections (tinea) are classified by the body site affected — tinea corporis (body), tinea pedis (feet, athlete’s foot), tinea cruris (groin) and tinea capitis (scalp) — and are diagnosed by their classic annular, scaling appearance and confirmed with KOH preparation microscopy. Candidal infections favour moist, occluded areas (skin folds, mucosal surfaces) and classically present with satellite lesions surrounding the main area of redness — a specific finding that helps distinguish candidal intertrigo from a simple dermatophyte infection in a similar location.

Scabies: recognising the distribution pattern

Scabies, caused by the mite Sarcoptes scabiei, causes intense itching that classically worsens at night, with burrows (thin, thread-like tracks) as the pathognomonic finding. The distribution pattern is genuinely diagnostic on its own — interdigital web spaces, wrists, axillae, and in infants, the palms and soles (areas typically spared in older children and adults). Recognising this specific distribution, rather than treating scabies as a generic itchy rash, is what the exam actually tests.

Skin cancers: appearance and behaviour

Basal cell carcinoma is the most common skin cancer, classically presenting as a pearly, raised nodule with visible telangiectasias, growing slowly and rarely metastasising — locally destructive rather than systemically dangerous. Squamous cell carcinoma presents as a scaly, often ulcerated or crusted lesion, arising more commonly on sun-exposed areas and carrying a real, though still relatively low, metastatic potential. Melanoma is the most dangerous of the three despite being less common, and the ABCDE features (Asymmetry, Border irregularity, Colour variation, Diameter over 6mm, Evolution or change over time) are the standard framework for recognising a concerning pigmented lesion warranting biopsy.

Acne: pathogenesis drives treatment choice

Acne vulgaris develops through a combination of four interacting factors — increased sebum production, follicular hyperkeratinisation (blocking the follicle), colonisation by Cutibacterium acnes, and the resulting inflammation — and understanding this sequence explains why treatment is typically layered rather than relying on a single agent. Topical retinoids address the hyperkeratinisation; benzoyl peroxide and topical or oral antibiotics address the bacterial component and inflammation; and for more severe or resistant cases, oral isotretinoin addresses multiple factors simultaneously, though it carries a significant teratogenicity risk requiring strict pregnancy prevention protocols during use. Recognising which factor a given treatment targets makes the overall treatment ladder far more logical than memorising a flat list of options.

Vitiligo: an autoimmune pigment disorder

Vitiligo results from autoimmune destruction of melanocytes, producing well-demarcated, depigmented (not just lighter) macules and patches, often symmetric and favouring areas like the face, hands and body folds. It is worth distinguishing clearly from other causes of hypopigmentation, since vitiligo specifically involves complete loss of melanocytes rather than reduced melanin production — a distinction that matters both for prognosis and for recognising its associations with other autoimmune conditions (thyroid disease in particular), which is why a vitiligo diagnosis sometimes prompts broader autoimmune screening.

Urticaria: the transient lesion worth recognising separately

Urticaria (hives) is worth calling out specifically because it behaves differently from the other lesions in this guide — individual wheals are transient, typically resolving within 24 hours and leaving no residual mark, unlike the more persistent lesions of psoriasis or eczema. This transience is itself a diagnostic clue: a rash a patient describes as moving around, or resolving and reappearing in different spots over the course of a day, is far more consistent with urticaria than with a fixed dermatosis. Acute urticaria is often allergic or related to a viral illness, while chronic urticaria (lasting more than six weeks) more often has no identifiable external trigger and may relate to an underlying autoimmune process — a distinction that shapes how far the workup is typically pursued.

A smart study plan for FMGE Dermatology

• Nail down the primary and secondary lesion vocabulary first — nearly every other dermatology topic assumes you can correctly identify what is being described.
• Learn conditions in contrasting pairs (psoriasis vs eczema, basal cell vs squamous cell vs melanoma) rather than studying each in isolation, since that is the form most questions actually take.
• Treat the SJS/TEN spectrum as a single continuum defined by body surface area, not as separate, unrelated diagnoses.
• Use the ABCDE framework actively for melanoma recognition — it is simple enough to apply quickly and is a reliably tested concept.

For the complete high-yield picture across every FMGE subject, see our FMGE high yield topics guide, and for how Dermatology fits into your overall timeline, our FMGE December 2026 preparation strategy covers the sequencing across subjects.