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Blue Naevus — SCE Dermatology MCQ

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HardSkin CancerBlue NaevusSCE Dermatology

A previously stable blue naevus has enlarged, become asymmetric and developed a new peripheral brown-black component over six months. What is the safest next step?

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Correct answer: D — Excise the changing lesion for complete histological assessment

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

C is correct. A stable, symmetric, homogeneous blue naevus can be observed, but documented enlargement, asymmetry or a new colour/structure invalidates that reassurance. Complete excision allows assessment of the entire architecture and depth and excludes melanoma arising in or mimicking a blue naevus. Cryotherapy destroys diagnostic tissue. Long surveillance delays a diagnosis that now has suspicious evolution, and partial shave sampling risks missing the diagnostically important deeper component. The management is driven by change, not by the lesion’s previous benign label.

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