Common Registration Assessment · Topic deep-dive
GPhC Skin Conditions Questions
The Board of Assessors’ June 2025 feedback singled out skin conditions as a weak area with a specific emphasis: “They are expected to know how common skin conditions present across diverse skin tones.” Most undergraduate teaching uses images and descriptions of conditions on light skin, leaving a recognised gap that the CRA is now testing.
What the GPhC actually tests on this topic
- Recognition of eczema, psoriasis, urticaria, acne, rosacea, fungal infections, and scabies on diverse skin tones
- Treatment selection: topical corticosteroid potency choice, antifungals, emollients
- Counselling on use of topical corticosteroids — strength, frequency, fingertip units, areas to avoid
- When to refer: red flags including suspected melanoma, severe drug eruptions, signs of secondary infection
- Common dermatological adverse drug reactions and how to identify them
Common pitfalls — from the Board of Assessors’ feedback
Erythema looking different on darker skin
Erythema is harder to see on darker skin tones. It may appear violaceous, dusky, or be visible only as warmth and induration. The Board of Assessors expects you to recognise inflammatory skin signs across all skin tones — the visible cue you trained on may not apply.
Misjudging topical corticosteroid potency
Hydrocortisone 1% is mild; clobetasol propionate 0.05% is super-potent. Wrong potency is the most common topical corticosteroid prescribing error and a recurring exam pattern. Know the four potency bands and which body areas tolerate which potency.
Missing serious drug eruptions
Stevens–Johnson syndrome, toxic epidermal necrolysis, and DRESS syndrome are drug-related dermatological emergencies. Know the typical onset window after starting the offending drug and the red-flag features (mucosal involvement, fever, lymphadenopathy).
Sample practice questions
CRA-style practice questions, not real exam questions. The Board of Assessors does not endorse third-party question banks.
A clinical pharmacist is reviewing Mr O'Brien, a 57-year-old male with co-existing AF on warfarin (target INR 2.0-3.0), frequent INR fluctuations, and CKD stage 3. Current medications include metformin 1 g BD, gliclazide 80 mg BD, ramipril 5 mg OD, and atorvastatin 40 mg ON. HbA1c 72 mmol/mol. Fasting glucose 12.4. eGFR 45. ACR 8 mg/mmol. In the context of this clinical picture, a patient diagnosed with type 2 diabetes is interested in lifestyle interventions to manage their condition. Which of the following recommendations is NOT appropriate?
- A. Engage in 150 minutes of moderate exercise weekly
- B. Follow a low-carbohydrate diet
- C. Limit alcohol intake to one drink per day
- D. Take a daily multivitamin
- E. Monitor blood glucose levels regularly
Show worked answer
Correct answer: D
Which type of dosage form is suitable for a drug with high first-pass metabolism to achieve systemic effects?
- A. Oral tablet
- B. Sublingual tablet
- C. Topical gel
- D. Rectal suppository
- E. Intramuscular injection
Show worked answer
Correct answer: B
Skin conditions — frequently asked
Why does the GPhC test skin conditions on darker skin tones?
Because most UK dermatological teaching uses imagery on light skin, leaving a recognised diagnostic gap when pharmacists assess patients with darker skin. The Board of Assessors explicitly flagged this in June 2025 feedback. The CRA tests whether you can recognise common conditions across the full range of skin tones you will see in practice.
Which resources show skin conditions on diverse skin tones?
The DFTB Skin Deep project, Mind The Gap by Black & Brown Skin, and the British Association of Dermatologists patient information leaflets show images across skin tones. The NHS website has been updated to include diverse-skin-tone imagery for common conditions. These are good supplementary references alongside the BNF.
What topical corticosteroid potency is appropriate where?
Mild (e.g. hydrocortisone 1%) for face, flexures, and infant eczema. Moderate (e.g. clobetasone butyrate 0.05%) for most adult body eczema. Potent (e.g. betamethasone valerate 0.1%) for severe eczema or short courses on resistant areas. Very potent (e.g. clobetasol propionate 0.05%) for short, specialist-supervised use only — usually palms, soles, or scalp.
Practise skin conditions questions in context
Across the full bank of GPhC exam questions — every format, with worked answers grounded in the Board of Assessors’ published feedback.