Dermatologist Certificate Skin Cancer Pathology and Oncology 1 — Questions and Answers
Question 1: What is the most common type of skin cancer in the United States?
- Basal cell carcinoma (BCC) (Correct answer)
- Squamous cell carcinoma (SCC)
- Melanoma
- Merkel cell carcinoma
Correct answer: Basal cell carcinoma (BCC)
Basal cell carcinoma is the most common human malignancy, accounting for approximately 80% of all non-melanoma skin cancers and affecting millions of Americans annually.
Question 2: Which histological subtype of basal cell carcinoma carries the highest risk of recurrence and invasion?
- Morpheaform (sclerosing/infiltrative) BCC (Correct answer)
- Nodular BCC
- Superficial BCC
- Pigmented BCC
Correct answer: Morpheaform (sclerosing/infiltrative) BCC
Morpheaform BCC has indistinct clinical borders with finger-like projections extending well beyond the visible lesion, making it the most aggressive subtype with the highest recurrence rate.
Question 3: Squamous cell carcinoma arising in a chronic wound or scar is known as which eponymous carcinoma?
- Marjolin ulcer (Correct answer)
- Bowen disease
- Paget disease
- Spiegler tumor
Correct answer: Marjolin ulcer
Marjolin ulcer is SCC arising from chronic wounds, burn scars, osteomyelitis sinuses, or other areas of chronic inflammation, typically with an aggressive course and higher metastatic risk.
Question 4: What feature of melanoma on dermoscopy is most specific for malignancy?
- Blue-white veil overlying raised areas (Correct answer)
- Uniform pigment network
- Symmetrical globules
- Regular dermoscopic structures
Correct answer: Blue-white veil overlying raised areas
The blue-white veil — an irregular, structureless, ground-glass blue area with overlying white haze — is a dermoscopic feature highly specific for invasive melanoma.
Question 5: PD-1 checkpoint inhibitors (nivolumab, pembrolizumab) are approved for which stage of melanoma?
- Advanced/metastatic melanoma and high-risk resected stage III/IV adjuvant therapy (Correct answer)
- Stage I thin melanoma
- In situ melanoma
- Lentigo maligna melanoma only
Correct answer: Advanced/metastatic melanoma and high-risk resected stage III/IV adjuvant therapy
Anti-PD-1 immunotherapy is approved for unresectable or metastatic melanoma and as adjuvant therapy for high-risk resected stage III and stage IV melanoma to reduce recurrence.
Question 6: BRAF V600E mutation is found in approximately what percentage of cutaneous melanomas?
- 50–60% of cutaneous melanomas (Correct answer)
- 10–15% of cutaneous melanomas
- 80–90% of cutaneous melanomas
- 5% of cutaneous melanomas
Correct answer: 50–60% of cutaneous melanomas
BRAF V600E mutations are present in approximately 50–60% of cutaneous melanomas, making BRAF/MEK inhibitor combination therapy (e.g., dabrafenib/trametinib) applicable to a large proportion of patients.
Dermatologist Certificate Skin Cancer Pathology and Oncology 1
What is the most common type of skin cancer in the United States?