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Body Dysmorphic Disorder — SCE Dermatology MCQ

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HardPsychodermatologyBody Dysmorphic DisorderSCE Dermatology

A 28-year-old woman presents to clinic requesting mole removal. She has no concerning clinical features but is distressed about the appearance of a 5 mm symmetrical compound naevus on her cheek. She has previously had 12 moles removed elsewhere (all benign) and remains dissatisfied, focusing on new perceived defects after each removal. What underlying condition should be considered?

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Correct answer: B — Body dysmorphic disorder

The best answer is “Body dysmorphic disorder”. 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 “Generalised anxiety disorder”, “Health anxiety”, “Major depressive disorder”, “Obsessive-compulsive disorder” 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