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Actinic Prurigo — SCE Dermatology MCQ

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HardPhotobiologyActinic PrurigoSCE Dermatology

A primary melanoma has been completely excised and staged as IIA. There is no recurrent or metastatic disease and no current indication for targeted treatment. What does NICE advise about BRAF analysis of the primary tumour?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Consider BRAF analysis at stage IIA rather than making it mandatory

Explanation lettering: C = shown as B · B = shown as C · E = shown as D · D = shown as E

E is correct. NICE distinguishes stage IIA from the adjacent stages: BRAF analysis may be considered for stage IIA primary melanoma, is not offered routinely for stage IA or IB at presentation, and should be carried out for stage IIB to IV disease. The purpose is to have molecular information available if systemic options become relevant, while avoiding indiscriminate testing in low-stage disease. Tissue testing is preferred; a serum assay is not the routine substitute proposed here. Sentinel-node positivity is not required before the stage-IIA recommendation can be considered.

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