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Melanoma — RACP Adult Medicine MCQ

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EasyGastroenterologyMelanomaRACP Adult Medicine

A 50-year-old man presents with a 2 cm pigmented skin lesion on his back. It has irregular borders, colour variation (brown, black, red), and asymmetry. Dermoscopy shows blue-white veil and irregular dots/globules. What is the most likely diagnosis?

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Correct answer: B — Melanoma

Asymmetry, border irregularity, colour variation, and dermoscopic features of blue-white veil and irregular dots/globules are high-risk features for melanoma. ABCDE criteria (Asymmetry, Border, Colour, Diameter, Evolution) guide clinical suspicion. Excision biopsy with 2 mm margins is the initial diagnostic procedure. Incisional or punch biopsy is contraindicated.

Reference: Cancer Council Australia – 2024 – Melanoma Guidelines; NCCN 2025