Derm SAQs ·
Skin cancer staging and management algorithms — SAQ
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A 62-year-old fair-skinned man is referred with two problems: (A) a changing 9 mm irregular pigmented lesion on the upper back, and (B) a 2.8 cm poorly differentiated ulcerated plaque on the left ear in a long-term renal transplant recipient. You must plan biopsy, staging logic and initial management pathways for both lesions without mixing melanoma and NMSC rules.
Questions
a) For lesion A (suspected melanoma), state the preferred biopsy technique and list the pathology elements required for AJCC 8th T category. (2 marks)
b) After histology shows a 1.1 mm non-ulcerated melanoma, outline wide local excision margin concept and whether sentinel lymph node biopsy should be discussed. (2 marks)
c) For lesion B (ear cSCC in a transplant patient), name at least three high-risk features and explain how BWH-style risk counting changes nodal assessment. (3 marks)
d) Contrast how localised BCC is “staged/risk-stratified” versus melanoma TNM, and give one systemic option each for advanced cSCC and advanced BCC. (3 marks)