PAEA Surgery End Of Rotation (EOR) Practice Exam

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What appearance characterizes nodular basal cell carcinoma (BCC)?

Flat scaly patches
Brown or black discoloration
Pearly white or pink dome-shaped papule
Ulcerated lesions with raised borders

The correct answer is: Pearly white or pink dome-shaped papule

Nodular basal cell carcinoma (BCC) is characteristically presented as a pearly white or pink dome-shaped papule. This appearance is primarily due to the proliferation of basal cells, which gives the lesion its distinctive, shiny quality. The dome shape is a key identifier and often has a translucent quality, allowing the underlying small blood vessels to sometimes be visible. Understanding this specific morphology is crucial for accurate diagnosis and differentiation from other skin lesions. While other options might describe different skin lesion types—flat scaly patches are often associated with squamous cell carcinoma or actinic keratosis, brown or black discoloration may indicate melanoma, and ulcerated lesions with raised borders can be seen in more advanced or different types of skin cancers—none exhibit the classic characteristics of nodular basal cell carcinoma as clearly as the pearly white or pink dome-shaped papule. This unique appearance is one of the foundational aspects in recognizing and diagnosing nodular BCC in clinical practice.