Daily Targets

• Read/Revise ~8 hours/day (blocks of 60–75 min + 10–15 min breaks).
• Solve 140–160 MCQs/day (25–30 per block, timed) with an error log.
• Make 4–6 mini‑cards/day (signs, differentials, first‑line therapy, dosages, adverse effects).
• End each day with 15‑minute Rapid Recap (diagnostic ladders; drug potency ladders; red‑flag emergencies).

Day 1 — Basics, Morphology, Infections, Eczemas/Dermatitis

Skin basics & morphology

• Layers: epidermis (strata), dermis, panniculus; adnexal structures.
• Primary lesions: macule, patch, papule, plaque, nodule, vesicle, bulla, pustule, wheal.
• Secondary lesions: scale, crust, lichenification, excoriation, fissure, erosion/ulcer, atrophy, scar, eschar.
• Distribution/configuration terms: linear, annular, arcuate, reticulate, dermatomal, photo‑distribution, extensor vs flexural.

Diagnostic tools

• KOH mount (dermatophyte hyphae vs Candida pseudohyphae/budding yeast); Woods lamp (coral‑red erythrasma; yellow‑green tinea capitis certain species, depigmentation in vitiligo); Tzanck (acantholytic cells, multinucleated giant cells); patch test (allergic contact dermatitis); diascopy (blanching—telangiectasia vs purpura); dermoscopy snapshot (comedo‑like openings in SK; arborizing vessels BCC; pigment network melanocytic).

Dermoscopy must‑knows (INI‑CET)

• Psoriasis: regular dotted vessels, diffuse white scaling (Auspitz tie‑in).
• Lichen planus: Wickham striae, radial capillaries.
• Melanoma cues: atypical pigment network, blue‑white veil, irregular streaks, multiple colors.
• BCC: arborizing vessels, maple‑leaf areas, spoke‑wheel structures.
• Dermatofibroma: central white scar‑like area with peripheral pigment network (dimple sign clinically).
• Seborrheic keratosis: milia‑like cysts, comedo‑like openings.
• Tinea capitis (black‑dot): comma/corkscrew hairs; alopecia areata: exclamation‑mark/yellow dots.

Bacterial infections

• Impetigo: non‑bullous vs bullous; honey‑colored crusts; complications (PSGN idea).
• Cellulitis/erysipelas: borders, systemic signs; first‑line antibiotics concept.
• Folliculitis/furuncles/carbuncles: staph predominance; drainage vs antibiotics.
• Erythrasma: coral‑red on Wood’s; macrolides/topicals.
• Cutaneous TB (India‑relevant): lupus vulgaris (apple‑jelly on diascopy), scrofuloderma (sinus tracts from nodes), TB verrucosa cutis; workup concept (Mantoux/IGRA, histology, CBNAAT where applicable).

Viral infections

• HSV‑1/2: grouped vesicles on erythematous base; Tzanck +; acyclovir class.
• VZV: chickenpox primary; shingles—dermatomal; post‑herpetic neuralgia risk.
• HPV warts: common/plantar/flat; cryotherapy/keratolytics; anogenital overview.
• Molluscum: umbilicated papules; curettage/topicals.
• Measles/rubella exanthems (pattern recall) for image‑based questions.

Fungal & parasitic infections

• Dermatophytosis: tinea corporis/pedis/cruris/capitis/unguium; KOH branching septate hyphae; topical azoles/allylamines; systemic therapy for capitis/unguium/widespread.
• Pityriasis versicolor: Malassezia; spaghetti‑and‑meatballs on KOH; hypopigmented patches.
• Candidiasis: intertrigo, angular cheilitis, paronychia; satellite pustules.
• Deep mycoses (snap): sporotrichosis (lymphatic spread), chromoblastomycosis (Medlar bodies).
• Scabies: burrows in web spaces; nocturnal pruritus; treat contacts; post‑scabietic itch awareness.
• Pediculosis: capitis/corporis/pubis; nits; permethrin.
• Larva migrans/cutaneous leishmaniasis (overview) for tropical image stems.

Eczemas & dermatitis

• Atopic dermatitis: flexural eczema; atopic triad; emollients, topical steroids/calcineurin inhibitors; infection control.
• Contact dermatitis: irritant vs allergic; patch testing; avoidance + topical therapy.
• Seborrheic dermatitis: scalp/nasolabial folds; antifungals + low‑potency steroid.
• Nummular eczema, stasis dermatitis snapshots.
• Urticaria/angioedema: acute vs chronic, triggers; non‑sedating antihistamines step‑up; anaphylaxis basics.

Venereology (STIs) — India‑relevant (DVL)

• Syndromes to recognize (NACO‑style): urethral discharge; vaginal discharge; genital ulcer non‑herpetic; genital ulcer herpetic; lower abdominal pain/PID; inguinal bubo; scrotal swelling. Know first‑line empiric bundles and partner management (concept level; platform‑specific regimens avoided here).
• Urethral discharge (male):
  • Gonorrhea (NG): abrupt purulent discharge, dysuria; Gram‑negative intracellular diplococci on smear.
  • Chlamydia (NGU): mucoid discharge; smear often negative; NAAT preferred.

• Vaginal discharge (female):

  • BV: thin, homogenous, fishy odor; clue cells; positive whiff.
  • Trichomoniasis: frothy greenish discharge; strawberry cervix.
  • Candida: thick curdy white; intense itch; pseudohyphae on KOH.

• Genital ulcer differential (painful vs painless):

  • Painless: Syphilis (hard chancre, indurated base, clean floor; painless nodes), LGV (transient painless ulcer → tender bubo with groove sign).
  • Painful: Chancroid (soft, ragged, undermined edges; painful nodes suppurate), Herpes (grouped vesicles → painful erosions), Donovanosis/Granuloma inguinale (beefy red, bleeds on touch; Donovan bodies on smear).

• Syphilis quick map:

  • Primary: hard chancre.
  • Secondary: generalized rash incl. palms/soles, mucous patches, condyloma lata.
  • Latent/Tertiary: gummas, neuro‑/cardio‑syphilis (concept).
  • Tests: non‑treponemal (RPR/VDRL) for screening & monitoring; treponemal (TPHA/FTA‑ABS) for confirmation.
  • Jarisch–Herxheimer reaction awareness after therapy.

• HIV testing & counselling (concept): window period; baseline tests; PEP/PrEP idea; coinfections screen (HBV/HCV/syphilis/TB); PMTCT concept.

• STI management principles: syndromic bundles; treat partners, abstain till cure, condoms/behavioural counselling; screen for other STIs.

Day‑1 MCQs focus**

• Primary vs secondary lesions; KOH/Tzanck/Woods; impetigo vs cellulitis; tinea vs Candida; scabies signs & management; atopic vs contact; seborrheic dandruff pearls.

Day 2 — Papulosquamous, Pigmentary, Acne/Rosacea, Hair/Nail, Bullous, Tumors, Connective‑tissue/Vasculitis, Leprosy, Pharmacology, Phototherapy, Procedures, Emergencies

Papulosquamous disorders

• Psoriasis: plaque/guttate/pustular/erythrodermic; Auspitz, Koebner; nail pitting/onycholysis; arthritis pointers; therapy ladder (topicals → phototherapy → systemic—MTX, cyclosporine, retinoids; biologics targets: TNF‑α, IL‑17, IL‑23—concept only).
• Lichen planus: 6 Ps; Wickham striae; oral/genital involvement; associations idea; topical/systemic steroids.
• Pityriasis rosea: herald patch; Christmas‑tree distribution; self‑limiting; symptomatic relief.
• Pityriasis rubra pilaris vs psoriasis (islands of sparing) — image clue.

Pigmentary disorders

• Vitiligo: depigmented macules; Koebner; segmental vs non‑segmental; therapy (topical steroids/calcineurin, NB‑UVB); camouflage.
• Melasma: centrofacial/malar/mandibular patterns; sunscreen, hydroquinone/triple combo; trigger control.
• PIH/PIHypo: prevention & gradual fade.
• Albinism vs piebaldism exam cues; café‑au‑lait (NF1 link).

Acneiform & rosacea

• Acne vulgaris: comedonal/inflammatory/nodulocystic; pathogenesis (follicular keratinization, sebum, Cutibacterium); therapy ladder (topical retinoid backbone ± BPO ± topical antibiotics; systemic antibiotics; isotretinoin—teratogenicity & labs concept); steroid acne idea; acne fulminans snapshot.
• Rosacea: flushing, telangiectasia, papulopustular; triggers; topical metronidazole/ivermectin; systemic tetracyclines; ocular rosacea awareness.

Hair & nail disorders (snapshots)

• Alopecia areata: exclamation mark hairs; nail pitting; intralesional steroids.
• Androgenetic alopecia: patterned loss; minoxidil/finasteride concepts.
• Telogen effluvium: trigger history; reassurance.
• Cicatricial alopecias (idea): lichen planopilaris/discoid lupus clues.
• Nails: onychomycosis (KOH/culture), onycholysis (psoriasis/thyrotoxicosis), clubbing vs koilonychia, Beau’s/Mee’s lines.

Bullous diseases

• Pemphigus vulgaris: flaccid bullae; mucosal involvement; Nikolsky +; anti‑desmoglein 3; DIF: intercellular IgG—"fish‑net"; systemic steroids + adjuvants.
• Bullous pemphigoid: tense bullae; elderly; Nikolsky −; hemidesmosomal BP180/230; DIF: linear IgG/C3 at BMZ; systemic/topical steroids.
• Dermatitis herpetiformis: intensely pruritic grouped vesicles; celiac association; dapsone + gluten‑free approach.

Tumors & premalignant lesions

• Benign: seborrheic keratosis (stuck‑on), dermatofibroma (dimple sign), lipoma, trichoepithelioma (adnexal) snapshot.
• Actinic keratosis → SCC risk.
• BCC: pearly papule with telangiectasia, rolled borders; low metastasis; surgical/ED&C options.
• SCC: ulcerating/crusted plaque; risk: sun, scars; nodal spread risk.
• Melanoma: ABCDE; superficial spreading vs nodular; excision margins concept; sentinel node idea.
• Neurocutaneous syndromes: NF1 (café‑au‑lait, axillary freckling, neurofibromas), TSC (angiofibromas, shagreen patch, ash‑leaf).

Leprosy (Hansen disease) — High‑yield for DVL

• Cardinal features: (1) Hypopigmented/erythematous anaesthetic patch; (2) thickened peripheral nerve; (3) AFB on slit‑skin smear.
• Ridley–Jopling spectrum: TT ↔ BT ↔ BB ↔ BL ↔ LL; cell‑mediated immunity highest at TT, lowest at LL; histoid leprosy snapshot; Lucio phenomenon (advanced BL/LL) awareness.
• WHO classification & MDT (concept): PB (≤5 lesions, 1 nerve) vs MB (>5 lesions or smear +); MDT PB vs MDT MB regimen idea; reaction management (Type 1 reversal with steroids; Type 2 ENL may need thalidomide where appropriate — concept only).
• Nerve involvement: ulnar, common peroneal, posterior tibial, greater auricular; claw hand, foot drop—awareness.
• Lepra reactions: Type 1 (upgrading/downgrading, neuritis); Type 2 (ENL, tender nodules, fever, systemic).

Connective‑tissue & vasculitis (exam‑style)

• Cutaneous lupus: malar rash/photosensitivity; discoid lesions; ANA idea.
• Dermatomyositis: heliotrope rash, Gottron papules, shawl sign; malignancy screen idea.
• Scleroderma/morphea: skin thickening; Raynaud concept.
• Vasculitis: palpable purpura (small‑vessel), livedo; Henoch–Schönlein purpura and PAN snapshots.

HIV & STI — India snapshot (add‑on)

• HIV staging & OIs (concept): candidiasis, PCP, toxoplasmosis pointers.
• PEP: start as early as possible after high‑risk exposure (concept); PrEP idea for prevention.
• Pregnancy/PMTCT: screening and ART continuation — concept level.

Pharmacology (derm‑relevant, exam style)

• Topical steroids: potency ladder; adverse effects (atrophy, striae, telangiectasia, HPA suppression rare); fingertip unit dosing.
• Retinoids: topical vs systemic; isotretinoin teratogenicity, mucocutaneous AEs, LFT/lipids monitoring concept.
• Calcineurin inhibitors: tacrolimus/pimecrolimus—site uses.
• Antifungals: azoles vs allylamines; systemic (terbinafine/itraconazole) hepatic caution.
• Antihistamines: sedating vs non‑sedating; urticaria ladder.
• Phototherapy: NB‑UVB vs PUVA indications; adverse effects concept.
• Systemic immunosuppressants: MTX, cyclosporine—high‑level indications/monitoring idea.

Dermatologic emergencies (red flags)

• SJS/TEN: drug triggers; mucosal involvement; body surface area split; supportive/burn care principles.
• DRESS vs AGEP vs morbilliform drug eruption: key separators (eosinophilia, facial edema; pustules/fever; timing after drug start).
• Fixed drug eruption (FDE): recurrent same‑site dusky patch; culprit recall.
• Erythroderma: causes (psoriasis, eczema, drugs); fluids/temp control; identify trigger.
• Angioedema/Anaphylaxis: airway first; epinephrine concept.

Procedural dermatology (basics)

• Skin biopsy: punch vs excision vs shave—when to choose.
• Cryotherapy & electrodessication: common indications; scar/PIH caution.
• Basic wound care & suturing pointers.

Day‑2 MCQs focus

• Psoriasis signs & therapy ladder; biologic targets (high‑level); LP 6 Ps; PR vs psoriasis (islands of sparing for PRP clue).
• Vitiligo vs tinea versicolor; melasma key therapies; albinism vs piebaldism.
• Acne ladder & isotretinoin AEs; rosacea triggers.
• Alopecia areata vs tinea capitis dermoscopy; cicatricial vs non‑cicatricial cues.
• Pemphigus vs pemphigoid DIF patterns; DH vs BP clue.
• BCC vs SCC vs melanoma; NF1 vs TSC hallmark lesions.
• Leprosy classification & reactions; Lucio/histoid awareness.
• CUT connective‑tissue/vasculitis identifiers (DM, DLE); drug eruptions (DRESS/AGEP/FDE vs morbilliform); SJS/TEN hallmarks; topical steroid potency.
• Phototherapy indications; biopsy type selection.

1‑Day Revision Plan (Post‑Study)

Day R — High‑Yield Blitz (8 h; ~150 MCQs)

• Infections: tinea KOH findings; scabies treatment & contacts; impetigo vs cellulitis.
• Papulosquamous: psoriasis nail changes & systemic options; LP oral/genital variants.
• Pigmentary: vitiligo therapy & Wood’s; melasma triggers & triple combo.
• Acne/rosacea: stepwise therapy; isotretinoin monitoring; trigger control.
• Bullous: DIF patterns; Nikolsky sign; first‑line systemic choices.
• Tumors: ABCDE; BCC pearly/rolled border; actinic keratosis → SCC risk.
• Pharmacology: steroid ladder, fingertip unit; antifungal choices.
• Emergencies: SJS/TEN recognition; erythroderma stabilization.

Heat‑Map: High‑Yield Focus

• Very High: morphology + diagnostic tests; dermatophytosis vs Candida; STI syndromes; syphilis stages & tests; psoriasis (incl. biologic targets); pemphigus vs bullous pemphigoid; topical steroid potency & AEs; SJS/TEN; leprosy MDT & reactions.
• High: acne therapy ladder; vitiligo vs melasma; BCC/SCC vs melanoma recognition; lichen planus; drug eruptions (DRESS/AGEP/FDE); connective‑tissue markers (DM/DLE); phototherapy basics.
• Moderate: pityriasis rosea, seborrheic dermatitis, molluscum, onychomycosis, alopecia areata; cutaneous TB; neurocutaneous syndromes.

Practice Pattern (all days)

• Timed MCQ blocks → immediate key‑learning note per error.
• Vignette flow: identify lesion type + distribution → choose best test (KOH/Tzanck/Wood’s/biopsy) → pick first‑line therapy → list contraindications/AEs.
• Mini‑cards set: lesion morphology; KOH/Tzanck/Wood’s map; tinea treatment by site; steroid potency ladder; isotretinoin AEs; pemphigus vs pemphigoid DIF; ABCDE melanoma; SJS/TEN red flags.

MCQ Gold‑Nuggets (must‑remember one‑liners)

• Auspitz + Koebner → psoriasis; regular dotted vessels on dermoscopy.
• Umbilicated papules → molluscum; coral‑red Wood’s → erythrasma.
• Grouped vesicles on erythematous base → HSV; dermatomal → shingles.
• Branching septate hyphae (KOH) → dermatophyte; spaghetti‑and‑meatballs → Pityrosporum.
• Nikolsky + / fish‑net DIF → pemphigus; Nikolsky − / linear BMZ DIF → bullous pemphigoid.
• Pearly papule + telangiectasia → BCC; ABCDE → melanoma screen.
• Isotretinoin → teratogenic (labs/contraception idea).
• Hard painless chancre + painless nodes → syphilis primary; palms/soles rash → secondary.
• Painful ragged ulcer + painful nodes → chancroid; painless ulcer → tender bubo + groove → LGV; beefy red bleeding + Donovan bodies → donovanosis.
• Urethral discharge: GC (purulent, Gram‑neg diplococci) vs NGU/chlamydia (mucoid, NAAT).
• Leprosy: anaesthetic patch + thickened nerve + AFB → think MDT; Type 1 vs Type 2 reactions.
• DRESS: eosinophilia + facial edema; AGEP: pustules + fever; FDE: same‑site dusky patch.
• Cutaneous TB: apple‑jelly on diascopy → lupus vulgaris.
• NF1: café‑au‑lait + axillary freckling; TSC: angiofibromas + ash‑leaf + shagreen.