Q&A Medicine>>>>>Dermatology
Question 1#

A 62-year-old man with an insignificant past medical history presents with anxiety about several “skin bumps.” He has a family history of melanoma and endorses spending much time in the sun as a child. Physical examination is unremarkable except for the lesion seen in the figure below (Figure below). 

Which of the following represents the most appropriate next step in management?

a. Shave biopsy
b. Reassurance
c. Excisional biopsy
d. Topical corticosteroids

Correct Answer is B

Comment:

Reassurance. The patient in this question is presenting with skin lesions that have a “stuck on” appearance with an overlying rough and scaly surface. This is a classic example of the common dermatologic condition known as seborrheic keratosis. Seborrheic keratoses are benign skin growths that require no treatment. (A, C) If there is doubt about the less common likelihood of nodular melanoma, a biopsy should be performed. Of note, the sudden appearance of many seborrheic keratoses can be a sign of a gastrointestinal malignancy.