Basal cell carcinoma — CCFP MCQ
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Correct answer: C — Basal cell carcinoma
Explanation lettering: D = shown as B · B = shown as D
The correct answer is C (Basal cell carcinoma). The stem describes the classic presentation of nodular BCC: a pearly papule with telangiectasia that enlarges slowly and bleeds easily. This triad—pearliness, telangiectasia, and bleeding—is pathognomonic. Seborrheic keratosis (A) is a benign, waxy, stuck-on lesion without telangiectasia or spontaneous bleeding. Actinic keratosis (B) is a scaly, rough, erythematous precancerous lesion without the pearly appearance or prominent telangiectasia of invasive BCC. Keratoacanthoma (D) grows rapidly (weeks) with a characteristic central keratin plug, not the slow growth described. Pyogenic granuloma (E) is a bright red, rapidly growing vascular lesion without pearliness. BCC is the most common skin malignancy and most commonly presents as nodular type with this exact clinical picture.
Reference: Barber et al. Canadian Non-melanoma Skin Cancer Guidelines Committee. Non-melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma. J Cutan Med Surg. 2015. https://pubmed.ncbi.nlm.nih.gov/25986316/