💊 Station 6 — Prescription Writing for Common Dermatological Disorders

Scabies / Psoriasis • Rapid Revision • Practical Skills • Viva

🎯 Task

CANDIDATE TASK

You are provided with a brief dermatological case and a blank prescription sheet. Write a complete and appropriate prescription, including the correct preparation, strength, method of application, frequency, duration and essential patient instructions.

⚡ Model Station Answer — What to say in the exam

I will first confirm the patient details, diagnosis, allergies and relevant contraindications, then write the prescription using generic drug names with the preparation, strength, application instructions, frequency, duration and quantity.

For uncomplicated adult scabies: permethrin 5% cream applied thoroughly to the appropriate whole-body area, left on overnight for approximately 8–12 hours and washed off, with a second application after 7 days. Close household contacts should be treated simultaneously.

For limited plaque psoriasis of the adult trunk or limbs: prescribe an appropriate potent topical corticosteroid once daily plus a vitamin-D analogue such as calcipotriol once daily at a different time, usually for an initial period of up to 4 weeks, together with regular emollient use and clear site-specific safety instructions.

🔎 Stepwise Procedure / Approach

Review the supplied case. Confirm whether the presentation is consistent with scabies or psoriasis and note the patient’s age, affected site, extent of disease, pregnancy status where relevant, allergies and current medicines.
Enter patient particulars. Write the patient’s name, age or date of birth, relevant identifiers and the date clearly.
Select the appropriate topical drug. Use the generic name and specify the preparation and strength rather than writing only the drug name.
Write precise application directions. State where the medicine is applied, how often it is used and any required contact time before washing.
Specify duration and quantity. The pharmacist and patient should be able to understand exactly how long treatment is intended to continue and how much preparation should be supplied.
For scabies, add transmission-control instructions. Treat close household contacts at the same time, repeat treatment after 7 days, and advise appropriate laundering or temporary isolation of recently used clothing, towels and bedding.
For psoriasis, add topical-treatment safety instructions. Use emollients regularly, apply active treatment only to affected plaques and avoid inappropriate use of potent corticosteroids on the face, flexures or genital skin.
Complete and check the prescription. Ensure the drug, strength, dosage form, route/site, frequency, duration and quantity are unambiguous, then sign and authenticate the prescription as required.

Exam point: Do not simply write “apply locally.” A good dermatology prescription tells the patient what preparation to use, where to apply it, how often, for how long and what important precautions to follow.

🖼️ Visual Learning

VISUAL 1

Correct Prescription Structure — Scabies vs Plaque Psoriasis

🎥 Practical Video

🎥 Practical Demonstration — How to Write a Prescription: Essential Components and Examples

Santiniketan Medical College & Hospital

This MBBS teaching demonstration reviews the correct structure of a prescription and works through practical prescription-writing examples. For this station, focus particularly on the prescription format, clear dosing instructions, topical preparations and the fingertip-unit discussion.

▶ Watch Practical Video

📝 Important Viva Questions

Q1. What essential drug information should be written in a prescription?

The generic drug name, preparation or dosage form, strength, dose or application instructions, route or site, frequency, duration and quantity to be supplied should be clear and unambiguous.

Q2. What is a commonly used first-line topical treatment for uncomplicated scabies?

Permethrin 5% cream is commonly used. Correct whole-body application and repetition of treatment after 7 days are important.

Q3. Why is the second scabies application given after about 7 days?

It helps eradicate mites that may have emerged after the initial treatment and reduces the risk of treatment failure or reinfestation.

Q4. Why should household contacts of a patient with scabies be treated simultaneously?

Asymptomatic contacts may still be infested and can reinfect the treated patient. Simultaneous treatment helps interrupt transmission.

Q5. What is a common initial topical strategy for limited plaque psoriasis on the adult trunk or limbs?

A potent topical corticosteroid once daily plus a vitamin-D analogue once daily at a different time is a commonly used initial approach, with regular emollient therapy.

Q6. Why must the site of application be considered when prescribing a topical corticosteroid?

Steroid potency must be appropriate for the skin site. Thin or sensitive areas such as the face, flexures and genital skin are more susceptible to adverse effects such as skin atrophy.

Q7. What is one common error in writing prescriptions for dermatological preparations?

Writing vague instructions such as “apply locally” without specifying the site, amount, frequency and duration. The instructions should allow the patient to use the treatment correctly without guessing.