QuestionSBA
QuestionChoice
Although a very important differential for any suspicious skin lesion, this patient does not have a malignant melanoma. Melanomas have varied appearances which are dependent on classification. The most common type of melanoma is superficial spreading which presents as a flat, irregular pigmented lesion. Other types of melanoma include nodular, lentigo maligna, acral lentiginous, amelanotic and many others. This patient, however, has presented with a classic basal cell carcinoma which can be identified by its central depression, telangiectasia and pearly rolled border in an area of sun-exposed skin.
10000418
c
Malignant melanoma
QuestionChoice
Actinic keratosis is a premalignant skin condition characterised by the presence of a small, scaly lesion found in an area of sun-damaged skin. Although this patient has the sun exposure risk factor for actinic keratosis, the lesion is not scaled and instead has a central depression and pearly, rolled border which is characteristic of basal cell carcinoma.
10000417
b
Actinic Keratosis
QuestionChoice
Cutaneous squamous cell carcinoma is a common skin malignancy arising from keratinocytes of the skin. As opposed to this patient's lesion, SCCs present as outwardly growing or sometimes ulcerated skin lesions which may be itchy or tender. SCCs sometimes grow from existing areas of skin trauma and commonly arise from areas of skin damage. However, this patient has presented with a centrally depressed skin lesion featuring a pearly rolled edge which is not found in SCC, therefore the diagnosis must be BCC.
10000419
d
Cutaneous squamous cell carcinoma
QuestionChoice
A seborrhoeic keratosis (SK) is a common benign skin lesion which classically appears as a well-defined keratinous growth which is often described as having a "stuck-on" appearance. However, this patient has not presented with a keratinous growth, but rather with a centrally depressed lesion with a pearly-rolled border which is much more typical of basal cell carcinoma.
10000420
e
Seborrheic Keratosis
QuestionChoice
This patient has a classical presentation of basal cell carcinoma (BCC). BCCs typically develop over sun-exposed skin such as the face and neck. There are several types of BCC. The most common is the nodular BCC which classically presents with a central depression with a pearly, rolled border. There may be telangiectasia across the centre. Other types of BCC include superficial, morphoeic, and basosquamous.
10000416
a
Basal cell carcinoma
Concept
Chapter
2693
3760
Basal cell carcinoma
Topic
144
Dermatology
12630
Picture
1502
basal_cell_carcinoma.jpg
images/isl37ybl1682079428853.jpg
images/isl37ybl1682079428853_256.jpg
images/isl37ybl1682079428853_512.jpg
4DgOFQSfeHaHWHZod3Z4h2B3ZWUG
Topic
144
Dermatology
A 60-year-old male presents to General Practice with a skin lesion on the back of his neck which he noticed 3 weeks ago. The patient recently returned to the UK after living and working in Spain for 20 years. On examination, you identify a 4mm skin lesion with a red central depression and a pearly rolled border.

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Which of the following is the most likely diagnosis?
a