Derm SAQs ·
Melanocytic pathology (naevus vs melanoma) — SAQ
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Stem
A 48-year-old fair-skinned man has a changing 9 mm irregular pigmented lesion on the upper back. Dermoscopy shows asymmetry and atypical network. You must plan biopsy, interpret the principles of naevus-versus-melanoma histology, and state how the pathology report and ancillary tests guide next steps.
Questions
a) State the preferred biopsy technique and explain why incomplete superficial shave is hazardous for staging. (2 marks)
b) List four architectural/cytologic features that favour melanoma over a compound naevus. (2 marks)
c) Name the essential AJCC-facing elements that must appear on an invasive melanoma histopathology report (at least four). (3 marks)
d) Explain the role and limitation of PRAME IHC, and how MPATH-Dx improves communication for ambiguous melanocytic lesions. (3 marks)