Dermatology
Skin cancer, common rashes and skin infections. Australia has the highest skin cancer rates in the world, so recognising melanoma, BCC and SCC is essential.
High-yield points
Melanoma: ABCDE for superficial spreading; EFG (elevated, firm, growing) for nodular melanoma, which may not be pigmented.
Suspicious pigmented lesion: complete excision biopsy with a 2 mm margin; do not shave or partially biopsy.
Definitive melanoma margins by Breslow thickness: in situ 5-10 mm, up to 1 mm thick 1 cm, 1-4 mm thick 1-2 cm, over 4 mm 2 cm.
BCC is the most common cancer; pearly, rolled edge, telangiectasia; locally invasive and rarely metastasises.
SCC: tender, keratotic, rapidly growing; higher risk in immunosuppressed transplant patients.
Actinic keratoses are precancerous; treat with cryotherapy or topical field therapy (e.g. fluorouracil).
Scabies: permethrin 5% cream, repeat after 7 days, treat all household contacts at the same time.
Eczema: emollients and adequate-strength topical corticosteroids; steroid phobia leads to under-treatment.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Skin cancer | Rare in darker skin types; little emphasis. | Very high rates; melanoma, BCC and SCC are daily GP work. Dermoscopy and GP excisions are expected skills. |
| Suspicious pigmented lesion | Refer to dermatology. | Excision biopsy with a narrow (about 2 mm) margin for suspected melanoma; don't shave or partially biopsy. |
| Common infections | Tinea (often with steroid-combination cream misuse), leprosy and scabies. | Leprosy is rare. Scabies and impetigo matter in remote communities. Use plain antifungals, no steroid combinations. |
| Prevention | Sun protection is not a public health focus. | SunSmart 'slip, slop, slap, seek, slide'. No national skin screening program; checks are targeted to higher-risk people. |
Skin cancer
India (MBBS)
Rare in darker skin types; little emphasis.
Australia (AMC): what the exam expects
Very high rates; melanoma, BCC and SCC are daily GP work. Dermoscopy and GP excisions are expected skills.
Suspicious pigmented lesion
India (MBBS)
Refer to dermatology.
Australia (AMC): what the exam expects
Excision biopsy with a narrow (about 2 mm) margin for suspected melanoma; don't shave or partially biopsy.
Common infections
India (MBBS)
Tinea (often with steroid-combination cream misuse), leprosy and scabies.
Australia (AMC): what the exam expects
Leprosy is rare. Scabies and impetigo matter in remote communities. Use plain antifungals, no steroid combinations.
Prevention
India (MBBS)
Sun protection is not a public health focus.
Australia (AMC): what the exam expects
SunSmart 'slip, slop, slap, seek, slide'. No national skin screening program; checks are targeted to higher-risk people.
The Australian context
Skin cancer is a daily part of Australian general practice, unlike in India where it is rare in darker skin types. Sun protection ('slip, slop, slap, seek, slide') is public health messaging everyone knows. There is no national population skin screening program; checks are opportunistic and targeted to higher-risk people.