Hair, nails & sweat glands flashcards
8 high-yield MRCP Part 1 cards from the Intellect Medicos Dermatology course. Try to answer each question before you open it — then study them properly with spaced repetition, which brings each card back just before you would forget it.
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Name three drugs that cause hypertrichosis (non-androgen-dependent excess hair).
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Any three: minoxidil, ciclosporin, phenytoin, diazoxide, corticosteroids.
Why? Unlike hirsutism, hypertrichosis is not androgen-driven and affects both sexes. Porphyria cutanea tarda is another cause.
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What is the first-line treatment for primary focal hyperhidrosis?
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Topical aluminium chloride (it can irritate the skin).
Why? It plugs eccrine sweat ducts.
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What is the classic triad of yellow nail syndrome?
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Yellow dystrophic nails, lymphoedema and respiratory disease (especially pleural effusions; also bronchiectasis and sinusitis).
Why? Nails are thickened, overcurved and grow very slowly.
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Which hair finding at the edge of a bald patch is characteristic of alopecia areata?
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"Exclamation mark" hairs — short broken hairs that taper towards the scalp.
Why? Alopecia areata is autoimmune and causes well-demarcated, non-scarring patches; nail pitting may coexist.
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What is the first-line approach to limited patchy alopecia areata in an adult?
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Watchful waiting is reasonable (regrowth is common); a potent topical or intralesional corticosteroid if treatment is wanted.
Why? Many patients regrow hair within a year without treatment. Extensive disease needs specialist referral.
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What is the mechanism of action of topical eflornithine for facial hirsutism?
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Irreversible inhibition of ornithine decarboxylase in the hair follicle, blocking putrescine (polyamine) synthesis and slowing hair growth.
Why? It slows growth rather than removing hair, so it is used alongside hair removal. Avoid in pregnancy and breastfeeding.
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How does botulinum toxin treat axillary hyperhidrosis?
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It blocks acetylcholine release from the sympathetic cholinergic nerve fibres that supply eccrine sweat glands.
Why? It is used when topical aluminium chloride fails; the effect lasts several months.
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Which adverse effects of finasteride carry MHRA warnings?
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Psychiatric effects (depression, suicidal thoughts) and sexual dysfunction (reduced libido, erectile dysfunction), which may persist after stopping.
Why? Finasteride inhibits type 2 5-alpha-reductase, reducing conversion of testosterone to dihydrotestosterone; oral 1 mg is used for male-pattern hair loss. Ask about depression or suicidal thoughts before prescribing; patients on 1 mg should stop it immediately and seek advice if these develop. A patient alert card is in every pack.