Benign & Malignant Lesions Practice MCQs- DPAP Fall 2026

A patient presents with dozens of waxy, "stuck-on" brown papules on the trunk. What is the most likely diagnosis?

A. Melanoma

B. Seborrheic keratosis

C. Actinic keratosis

D. Compound nevus

B. Seborrheic keratosis

A sudden eruption of numerous seborrheic keratoses should raise suspicion for:

A. Diabetes mellitus

B. Internal malignancy

C. Hyperthyroidism

D. Sarcoidosis

B. Internal malignancy

Dermatosis papulosa nigra is considered a variant of:

A. Melasma

B. Seborrheic keratosis

C. Vitiligo

D. Lentigo

B. Seborrheic keratosis

Stucco keratoses are most commonly found on:

A. Face and scalp

B. Trunk

C. Lower legs and ankles

D. Palms and soles

C. Lower legs and ankles

A soft pedunculated papule located on the neck is most likely:

A. Dermatofibroma

B. Acrochordon

C. Lipoma

D. Sebaceous hyperplasia

B. Acrochordon

Which location is most typical for a skin tag?

A. Palm

B. Axilla

C. Forearm

D. Sole

B. Axilla

A firm brown papule on the lower leg dimples inward when squeezed. What is the diagnosis?

A. Sebaceous hyperplasia

B. Dermatofibroma

C. BCC

D. Epidermal cyst

B. Dermatofibroma

The "dimple sign" is classically associated with:

A. Lipoma

B. Dermatofibroma

C. Melanoma

D. Lentigo

B. Dermatofibroma

A soft, mobile, rubbery subcutaneous mass is most consistent with:

A. Lipoma

B. Dermatofibroma

C. Epidermal cyst

D. Nevus

A. Lipoma

What is the preferred management for an asymptomatic lipoma?

A. Radiation

B. Cryotherapy

C. Observation

D. Mohs surgery

C. Observation

A mobile nodule with a central punctum containing cheesy keratinous material is most likely:

A. Lipoma

B. Epidermal cyst

C. BCC

D. Cherry angioma

B. Epidermal cyst

Recurrence of an epidermal cyst is most likely when:

A. Oral antibiotics are used

B. Contents are expressed

C. The cyst wall is not completely removed

D. Cryotherapy is performed

C. The cyst wall is not completely removed

A small yellow papule with central umbilication on the forehead is most likely:

A. Sebaceous hyperplasia

B. BCC

C. Molluscum contagiosum

D. Spitz nevus

A. Sebaceous hyperplasia

Sebaceous hyperplasia most commonly occurs on:

A. Forehead and cheeks

B. Palms

C. Legs

D. Soles

A. Forehead and cheeks

Fordyce spots are:

A. Ectopic sebaceous glands

B. Melanocytic tumors

C. Epidermal cysts

D. Viral papules

A. Ectopic sebaceous glands

Fordyce spots are most commonly found on:

A. Lips and buccal mucosa

B. Elbows

C. Scalp

D. Soles

A. Lips and buccal mucosa

Which type of nevus contains melanocytes exclusively at the dermal-epidermal junction?

A. Compound nevus

B. Blue nevus

C. Junctional nevus

D. Intradermal nevus

C. Junctional nevus

Which type of nevus typically appears as a raised papule because nevus cells are found in both the dermis and epidermis?

A. Junctional nevus

B. Compound nevus

C. Halo nevus

D. Blue nevus

B. Compound nevus

An intradermal nevus is most likely to be:

A. Flat and tan

B. Soft and flesh-colored

C. Black and ulcerated

D. Painful

B. Soft and flesh-colored

The blue appearance of a blue nevus results from:

A. Hemosiderin deposition

B. Tyndall effect

C. Keratin accumulation

D. Vascular congestion

B. Tyndall effect

A pigmented nevus surrounded by a depigmented ring is called:

A. Blue nevus

B. Spitz nevus

C. Halo nevus

D. Junctional nevus

C. Halo nevus

A rapidly growing pink dome-shaped papule in a child is most likely:

A. Melanoma

B. Spitz nevus

C. BCC

D. Compound nevus

B. Spitz nevus

Which nevus variant often resembles a "chocolate chip cookie"?

A. Halo nevus

B. Blue nevus

C. Nevus spilus

D. Junctional nevus

C. Nevus spilus

Freckles differ from solar lentigines because freckles:

A. Persist year-round

B. Fade during winter

C. Occur only in adults

D. Cannot darken

B. Fade during winter

Solar lentigines are most strongly associated with:

A. Autoimmune disease

B. UV exposure

C. Viral infection

D. Fungal infection

B. UV exposure

A 2-mm bright red papule on the trunk is most likely:

A. Cherry angioma

B. Venous lake

C. BCC

D. Melanoma

A. Cherry angioma

A soft compressible blue-purple papule on the lower lip is most likely:

A. Cherry angioma

B. Venous lake

C. Dermatofibroma

D. Lentigo

B. Venous lake

Spider angiomas commonly demonstrate:

A. Scale

B. Ulceration

C. Central arteriole with radiating vessels

D. Hyperkeratosis

C. Central arteriole with radiating vessels

Spider angiomas are commonly associated with:

A. Chronic liver disease

B. Celiac disease

C. Tuberculosis

D. Sarcoidosis

A. Chronic liver disease

Which pigment disorder is often called the "mask of pregnancy"?

A. Lentigo

B. Melasma

C. Vitiligo

D. Halo nevus

B. Melasma

First-line management of melasma includes:

A. Surgical excision

B. Antibiotics

C. Sunscreen

D. Systemic steroids

C. Sunscreen

Vitiligo results from:

A. Increased melanocyte activity

B. Autoimmune melanocyte destruction

C. Keratinocyte hyperplasia

D. Fungal infection

B. Autoimmune melanocyte destruction

Under Wood's lamp examination, vitiligo typically appears:

A. Coral-red

B. Bright blue-white

C. Yellow-orange

D. Green

B. Bright blue-white

The most common skin cancer worldwide is:

A. SCC

B. Melanoma

C. BCC

D. Merkel cell carcinoma

C. BCC

Which risk factor is most important in the development of BCC?

A. Gluten exposure

B. UV radiation

C. HPV infection

D. Diabetes

B. UV radiation

A pearly papule with telangiectasias and a rolled border is characteristic of:

A. SCC

B. Nodular BCC

C. AK

D. Melanoma

B. Nodular BCC

Which subtype of BCC is considered the least aggressive?

A. Morpheaform

B. Pigmented

C. Superficial

D. Nodular

C. Superficial

A scar-like white-yellow plaque with poorly defined borders is most suggestive of:

A. SCC

B. Morpheaform BCC

C. AK

D. Keratoacanthoma

B. Morpheaform BCC

Mohs surgery is particularly useful for:

A. Cherry angiomas

B. Morpheaform BCC

C. Freckles

D. Lipomas

B. Morpheaform BCC

Actinic keratoses arise primarily due to:

A. HPV infection

B. Chronic UV exposure

C. Autoimmune disease

D. Diabetes

B. Chronic UV exposure

The classic texture of an actinic keratosis is:

A. Waxy

B. Velvety

C. Sandpaper-like

D. Soft

C. Sandpaper-like

Actinic keratoses most commonly occur on:

A. Sun-exposed skin

B. Buttocks

C. Groin

D. Soles

A. Sun-exposed skin

A cutaneous horn should always prompt:

A. Observation only

B. Biopsy

C. Topical steroids

D. Mohs surgery

B. Biopsy

Induration at the base of an actinic keratosis raises concern for:

A. BCC

B. SCC

C. Vitiligo

D. Lentigo

B. SCC

Bowen disease is defined as:

A. Metastatic SCC

B. SCC in situ

C. Invasive melanoma

D. BCC variant

B. SCC in situ

Which factor is associated with SCC development?

A. HPV

B. UV exposure

C. Chronic inflammation

D. All of the above

D. All of the above

Keratoacanthoma classically presents as:

A. Red nodule with central keratin plug

B. Pearly papule

C. Blue macule

D. White patch

A. Red nodule with central keratin plug

Why should keratoacanthomas be biopsied?

A. They always metastasize

B. They resemble SCC

C. They are infectious

D. They are painful

B. They resemble SCC

The "A" in the ABCDE rule stands for:

A. Atypia

B. Asymmetry

C. Advancement

D. Architecture

B. Asymmetry

The "E" in the ABCDE rule stands for:

A. Erosion

B. Extension

C. Evolving

D. Elevation

C. Evolving

Which feature is MOST concerning for melanoma?

A. Uniform color

B. Symmetry

C. Recent change in appearance

D. Stable lesion

C. Recent change in appearance

Severe atypia in a dysplastic nevus is generally managed:

A. Observation only

B. Like melanoma

C. Cryotherapy

D. Laser therapy

B. Like melanoma

Malignant melanoma arises from:

A. Keratinocytes

B. Fibroblasts

C. Melanocytes

D. Sebaceous glands

C. Melanocytes

Which factor is the strongest prognostic indicator in melanoma?

A. Clark level

B. Tumor color

C. Breslow depth

D. Patient age

C. Breslow depth

Which melanoma subtype is the most common overall?

A. Nodular melanoma

B. Lentigo maligna melanoma

C. Acral lentiginous melanoma

D. Superficial spreading melanoma

D. Superficial spreading melanoma

Which melanoma subtype has the most aggressive vertical growth pattern?

A. Lentigo maligna melanoma

B. Nodular melanoma

C. Superficial spreading melanoma

D. Acral lentiginous melanoma

B. Nodular melanoma

Which melanoma subtype is most common in African American patients?

A. Nodular melanoma

B. Lentigo maligna melanoma

C. Acral lentiginous melanoma

D. Superficial spreading melanoma

C. Acral lentiginous melanoma

A melanoma occurring on the palms, soles, or beneath the nails is most likely:

A. Nodular melanoma

B. Superficial spreading melanoma

C. Acral lentiginous melanoma

D. Lentigo maligna melanoma

C. Acral lentiginous melanoma

An amelanotic melanoma typically appears:

A. Blue-black

B. Flesh colored only

C. Pink-red papule or nodule

D. Bright yellow

C. Pink-red papule or nodule

Which patient has the highest melanoma risk?

A. Dark skin and few nevi

B. Fair skin with multiple atypical nevi

C. Brown eyes without sun exposure

D. No family history

B. Fair skin with multiple atypical nevi