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Melanoma — MCCQE Part 1 MCQ

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ModerateSkin LesionsMelanomaMCCQE Part 1

A 49-year-old man presents with a pigmented lesion on his back that his partner says has enlarged and changed colour. It is asymmetric with irregular borders and multiple colours, measuring 9 mm. What is the most appropriate investigation?

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Correct answer: E — Excisional biopsy with narrow margins

ABCDE changes raise concern for melanoma, and excisional biopsy with narrow margins is preferred for diagnosis when feasible. Cryotherapy or steroid treatment would destroy or delay histology. Annual review is too delayed for a changing suspicious lesion. Superficial shave can impair accurate Breslow depth assessment.

Reference: Canadian Dermatology Association melanoma guidance