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Melanoma Biopsy — SCE Dermatology MCQ

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HardSkin CancerMelanoma BiopsySCE Dermatology

A widening longitudinal melanonychia band arises from the proximal nail matrix and has periungual pigmentation. Which sampling method best minimises false reassurance and permanent nail dystrophy?

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

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Correct answer: B — A planned matrix biopsy that includes the band origin

Longitudinal melanonychia is generated by matrix melanocytes, so the biopsy must sample the matrix origin of the suspicious band. Technique and orientation should be planned by an experienced nail surgeon to obtain representative tissue while limiting avoidable matrix scarring.

Reference: https://www.nice.org.uk/guidance/ng14/chapter/recommendations