Skin Tumors (Malignant Melanoma, SCC, BCC) MCQs

Dermatology · 23 free questions with answers & explanations.

1. A 60-year-old man presents with a pearly, translucent nodule with telangiectatic vessels over the nasal alar region. Central ulceration with a rolled everted edge is noted. There is no lymphadenopathy. Which histological subtype is most common?
2. A 55-year-old farmer presents with an irregular, crusted, rapidly growing nodule on the lower lip with a hard, fixed cervical lymph node. Biopsy shows keratin pearl formation with prickle cell layer invasion. What is the most important prognostic factor for this tumor?
3. A 55-year-old patient has a pigmented lesion on the palm with irregular borders. Dermoscopy shows a parallel ridge pattern. This pattern is characteristic of:
4. Keratoacanthoma is a rapidly growing squamoid neoplasm that may spontaneously regress. It is considered a variant of which entity for clinical management purposes?
5. Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) is caused by mutation in which tumour suppressor gene, and what is the associated intracranial calcification pattern?
6. The surgical excision margin for a primary cutaneous melanoma with Breslow thickness of 2.5 mm (T3a) according to current guidelines should be:
7. Dermoscopy of a pigmented basal cell carcinoma reveals which set of features MOST characteristic of this tumor type?
8. The sentinel lymph node biopsy (SLNB) in melanoma is recommended for tumours with Breslow thickness of ≥1 mm. The most important single histological prognostic factor in primary melanoma at the time of diagnosis is:
9. A 70-year-old patient with a non-healing ulcer on the lower lip, sun-damaged skin, and regional lymphadenopathy is found to have well-differentiated squamous cell carcinoma. The precursor lesion most directly leading to lip SCC is:
10. Vismodegib is approved for treatment of locally advanced and metastatic basal cell carcinoma. Its mechanism of action is:
11. A melanoma biopsy report reads: Clark level IV, Breslow thickness 2.2 mm, ulceration present, mitotic rate 3/mm², no microsatellitosis. According to the current AJCC staging, this would be staged as:
12. A 68-year-old with a 15-year history of chronic venous ulcer develops a rapidly growing fungating mass at the ulcer margin. Biopsy shows invasive squamous cell carcinoma. This specific SCC subtype arising from chronic non-healing wounds or scars is called:
13. Dermoscopy of a pigmented lesion shows a blue-white veil, irregular pigment network, pseudopods, and regression structures (white scar-like areas and blue-gray peppering). The most likely diagnosis is:
14. The sentinel lymph node biopsy (SLNB) threshold for melanoma is determined by Breslow thickness. In current guidelines, SLNB is ROUTINELY recommended for melanomas with Breslow thickness:
15. Merkel cell carcinoma (MCC) is a rare aggressive primary cutaneous neuroendocrine tumour. Most cases in immunocompetent patients are associated with:
16. The ABCDE dermoscopy algorithm for early detection of melanoma. Which additional letter (F) was added to address a common melanoma variant that lacks all ABCDE features?
17. Merkel cell carcinoma (MCC), a rare but aggressive primary cutaneous neuroendocrine tumour, is associated with which viral oncogen and immunosuppressed state?
18. The BRAF V600E mutation is found in approximately 50% of cutaneous malignant melanomas. The targeted therapy combination approved for BRAF-mutant metastatic melanoma uses:
19. The Clark's level of melanoma invasion that specifically corresponds to involvement of the papillary dermis (but not filling or expanding it) is:
20. A 55-year-old patient has a nodular malignant melanoma. The Breslow thickness is 2.1mm and Clark level IV. Sentinel lymph node biopsy is positive. Molecular testing shows BRAF V600E mutation. The targeted therapy combination that is standard of care is:
21. A biopsy from a pearly, telangiectatic nodule on the nasal ala of a 65-year-old shows islands of basaloid cells with peripheral palisading, retraction artifact (mucin), and surrounding stroma. The molecular pathway predominantly mutated is:
22. A 65-year-old man has a 2 cm lesion on the lower lip — a firm, indurated, non-healing ulcer with everted edges. Biopsy confirms well-differentiated squamous cell carcinoma. Which features of this SCC indicate HIGH risk of nodal metastasis requiring sentinel lymph node biopsy consideration?
23. A 45-year-old man presents with a 1.8 mm thick primary melanoma on the back (Clark level IV), no ulceration, mitotic rate 2/mm². SLNB is performed and shows a positive sentinel node (metastatic melanoma). Current staging (AJCC 8th) makes him: