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Melanoma — SCE Dermatology MCQ

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HardSkin CancerMelanomaSCE Dermatology

A 60-year-old man presents with a new pigmented lesion on his left cheek. Dermoscopy shows pseudopods and radial streaming at the periphery. This pattern is most suspicious for which diagnosis?

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Correct answer: B — Melanoma showing a peripheral radial-growth dermoscopic pattern

The best answer is “Melanoma showing a peripheral radial-growth dermoscopic pattern”. NICE bases melanoma diagnosis, excision margins and nodal assessment on complete histology, Breslow thickness, ulceration and clinical stage, with specialist review of suspicious or changing lesions. The alternatives “Pigmented basal-cell carcinoma showing blue-grey ovoid nests”, “Seborrhoeic keratosis showing comedo openings and milia-like cysts”, “Dermatofibroma showing a central white scar-like patch”, “Blue naevus showing homogeneous structureless blue pigmentation” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE NG14 melanoma recommendations: https://www.nice.org.uk/guidance/ng14/chapter/Recommendations