CDT Skin Cancer Screening & Education 2 — Questions and Answers
Question 1: Which dermoscopic feature is most associated with melanoma compared to a benign melanocytic nevus?
- Uniform pigment network
- Atypical pigment network with irregular meshwork (Correct answer)
- Comma-shaped vessels
- Arborizing telangiectasias
Correct answer: Atypical pigment network with irregular meshwork
An atypical pigment network with irregular, broadened, or broken meshwork is a key dermoscopic indicator of melanoma.
Question 2: A patient presents with a pearly, translucent papule with rolled borders and surface telangiectasias on the nose. The most likely diagnosis is:
- Squamous cell carcinoma
- Nodular basal cell carcinoma (Correct answer)
- Amelanotic melanoma
- Sebaceous hyperplasia
Correct answer: Nodular basal cell carcinoma
Nodular basal cell carcinoma classically appears as a pearly papule with rolled borders, surface telangiectasias, and central ulceration on sun-exposed areas.
Question 3: The Fitzpatrick skin phototype scale is used in skin cancer screening primarily to:
- Determine exact sun exposure history
- Assess UV sensitivity and skin cancer risk (Correct answer)
- Grade severity of existing lesions
- Classify lesion pigmentation depth
Correct answer: Assess UV sensitivity and skin cancer risk
The Fitzpatrick scale classifies skin types I–VI based on UV sensitivity and tanning ability, helping estimate skin cancer risk.
Question 4: Lentigo maligna most commonly occurs in which anatomical location?
- Trunk
- Lower extremities
- Sun-damaged facial skin in elderly patients (Correct answer)
- Nail unit
Correct answer: Sun-damaged facial skin in elderly patients
Lentigo maligna is an in situ melanoma that predominantly develops on the chronically sun-damaged facial skin of older adults.
Question 5: When educating a patient about self-skin exams, you should instruct them to examine themselves:
- Every 5 years if no personal history of skin cancer
- Monthly using a full-length mirror and hand mirror (Correct answer)
- Only when they notice a new lesion
- Annually under direct sunlight
Correct answer: Monthly using a full-length mirror and hand mirror
Monthly self-skin exams using a full-length and hand mirror allow for systematic head-to-toe surveillance of all skin surfaces.
Question 6: Merkel cell carcinoma is caused by which infectious agent in the majority of cases?
- Human papillomavirus (HPV)
- Herpes simplex virus (HSV)
- Merkel cell polyomavirus (MCPyV) (Correct answer)
- Epstein-Barr virus (EBV)
Correct answer: Merkel cell polyomavirus (MCPyV)
Merkel cell polyomavirus is integrated into the tumor genome in approximately 80% of Merkel cell carcinoma cases.
Question 7: A CDT performing a full-body skin exam should document lesion location using standardized body diagrams to:
- Replace physician documentation requirements
- Enable objective tracking of lesion changes over serial visits (Correct answer)
- Satisfy Medicare billing requirements automatically
- Avoid the need for dermoscopy
Correct answer: Enable objective tracking of lesion changes over serial visits
Standardized body diagrams allow consistent documentation so changes in lesion size, shape, or number can be objectively compared over time.
CDT Skin Cancer Screening & Education 2
Which dermoscopic feature is most associated with melanoma compared to a benign melanocytic nevus?