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Retired NBME 15 Answers

nbme15/Block 1/Question#31 (reveal difficulty score)
A 75-year-old woman comes to the physician ...
Lentigo maligna ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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Lentigo maligna is a type of melanoma (FA2020 p484), hence why it is important the lesion is brown/black with irregular borders and enlarging (all hallmarks of melanoma). The biopsy description also fits lentigo maligna, but even if you are not a pathologist the description that fits cancer and and "atypical melanocytes" should point you to lentigo maligna.

  • Acanthosis nigricans is thickening (acanthosis means epidermal hyperplasia) and darkening of skin in folds and creases associated with insulin resistance
  • Actinic keratosis is a premalignant lesion that is a small, rough, erethematous or brownish papule/plaque
  • Compound nevus is a type of mole that is slightly elevated, brown or light brown, and has regular borders. It is not fast-growing.
  • Sebhorreic keratosis are "stuck-on" flat, greasy, pigmented squamous epithelial proliferation of immature keratinocytes with keratin-filled cysts. Rapid onset of multiple indicates possible GI malignancy.

FA2020 p482, 477 and 484

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cheesetouch  fa2018 p 469 melanoma +1
randi  FA2019 p473 +1



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