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Melanoma — MCCQE Part 1 MCQ

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HardSkin LesionsMelanomaMCCQE Part 1

A 48-year-old woman has a pigmented lesion on her upper back that has enlarged over 8 months. It is asymmetric, has irregular borders, colour variation and diameter 9 mm. There is no palpable lymphadenopathy. What is the most appropriate investigation?

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Correct answer: B — Excisional biopsy with narrow margins

A changing lesion with ABCDE features is suspicious for melanoma, and excisional biopsy with narrow margins provides accurate Breslow depth. Shave or destructive treatment can impair staging if melanoma is present. Serum markers are not used to diagnose a primary suspicious skin lesion.

Reference: Canadian Dermatology Association melanoma guidance