A 32-year-old woman has multiple well-demarcated, erythematous, slightly scaly patches with thread-like border on the back. Biopsy shows superficial basaloid proliferation attached to the epidermis with peripheral palisading. The MOST appropriate first-line treatment is:

• A Topical imiquimod 5 percent cream ✓
• B Wide surgical excision with 4 mm margins
• C Radical radiotherapy to the whole back
• D Intralesional interferon alfa

Explanation

This is superficial basal cell carcinoma, which presents as multiple scaly plaques on the trunk of younger adults. Because tumour nests remain confined to the papillary dermis, topical agents such as imiquimod 5 percent or 5-fluorouracil are accepted first-line options for low-risk truncal lesions. Excision with 4 mm margins is reserved for higher-risk or thicker tumours, and radiotherapy is not given over large trunk fields.

Reference: Bolognia Dermatology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.