Question 11#
A 25-year-old woman with blonde hair and fair complexion complains of a mole on her upper back. The lesion is 8 mm in diameter, darkly pigmented and asymmetric, with an irregular border (shown below).
Which of the following is the best next step in management?
A. Tell the patient to avoid sunlightB. Follow the lesion for any evidence of growth
C. Obtain metastatic workup
D. Obtain full-thickness excisional biopsy
E. Obtain superficial shave biopsy
Correct Answer is D
Comment:
The lesion has characteristics of melanoma (remember the ABCDs: a symmetry, irregular or ill-defined border, dark black or variegated color, and diameter > 6 mm). A full-thickness excisional biopsy is required for diagnosis and should not be delayed. Shave biopsy of a suspected melanoma makes the assessment of depth of invasion difficult. Diagnosis is urgent; the lesion cannot be observed over time. After the diagnosis of melanoma is made, the tumor must then be staged to determine prognosis and treatment.