OSCE — Melanoma & Skin Cancer

Brief (to candidate)

You will assess a patient with a presentation consistent with Melanoma & Skin Cancer.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Skin cancer is the commonest malignancy worldwide and splits into melanoma (aggressive melanocytic cancer with high metastatic potential) and the non-melanoma skin cancers (NMSC) — basal cell carcinoma (BCC, commonest and locally invasive, rarely metastasises) and squamous cell carcinoma (SCC, keratinising, can metastasise to nodes) — plus the rarer, aggressive Merkel cell carcinoma (neuroendocrine, polyomavirus-related). Risk factors centre on ultraviolet radiation (sun exposure, sunburn, tanning beds), fair skin, freckles, red hair (MC1R), immunosuppression, older age, family/genetic predisposition (FAMM/CDKN2A, xeroderma pigmentosum, Gorlin), and previous skin cancer. Melanoma is recognis

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.^[2]