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Melanoma — SCE Dermatology MCQ

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ModerateSkin CancerMelanomaSCE Dermatology

A 55-year-old man with Fitzpatrick skin type I presents for his annual skin check. He has a history of dysplastic naevus syndrome and a first-degree relative with melanoma. Dermoscopy of a naevus on his back shows regular pigment network with a single focus of irregular streaks at the periphery. What is the most appropriate management?

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Correct answer: D — Short-term digital dermoscopic monitoring (3 months)

For lesions with equivocal dermoscopic features (in this case, an otherwise regular naevus with a single focus of irregular streaks), short-term digital dermoscopic monitoring at 3 months is appropriate to detect subtle changes over time. If morphological change is detected, excision is performed. This approach is recommended by BAD dermoscopy guidelines for equivocal lesions in high-risk patients. Immediate excision is appropriate for clearly suspicious lesions. 12-month follow-up risks missing an early melanoma. Punch biopsy may undersample.

Reference: BAD 2016 Dermoscopy Guidelines