Malignant Skin Lesions — Written Clinical Reasoning · Phys Written Answers

Prompt

DCE-style written reasoning for Malignant Skin Lesions.

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Malignant Skin Lesions and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Jones LS, McEldrew E, Bartus CL Review of Skin Depigmentation Practices and Cutaneous Malignancy J Clin Aesthet Dermatol, 2026.PMID 42459248
[2]Alheggi A Artificial Intelligence in Inherited Epidermolysis Bullosa: Current Evidence, Challenges, and Future Directions Diagnostics (Basel), 2026.PMID 42449804
[3]Ondrušová L, Kreisingerová K, Vachtenheim J MITF Is an Essential and Functionally Multifaceted Transcription Factor in Cutaneous Melanoma Cancers (Basel), 2026.PMID 42449703
[4]Erdem S, Amparore D, Re C, Verep S, et al. What should the urologist know on the management of kidney cancer in patients with Von Hippel-Lindau syndrome? Recommendations of the European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group World J Urol, 2026.PMID 42373875
[5]Leru PM, Anton VF, Georgescu DG Severe Persistent Hypereosinophilia of Undetermined Significance: Diagnostic Challenges in Clinical Practice and Two-Year Follow-Up Rom J Intern Med, 2026.PMID 42335361
[6]Nicer J, Kania J, Sobol M, Jurkiewicz D, et al. Impact of Anatomical Subsite on Achieved Surgical Margins in Head and Neck Basal Cell Carcinoma Otolaryngol Pol, 2025.PMID 42138045
[7]Xi Y, Yao T, Zhang C, Zhuang T Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial Perioper Med (Lond), 2026.PMID 42469924
[8]Marks FJ, Walters SJ, Sutton L, Jacques RM What statistical methods are more appropriate for predicting recruitment at the design stage of a randomised controlled trial? Trials, 2026.PMID 42469922

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Malignant Skin Lesions and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Jones LS, McEldrew E, Bartus CL Review of Skin Depigmentation Practices and Cutaneous Malignancy J Clin Aesthet Dermatol, 2026.PMID 42459248
[2]Alheggi A Artificial Intelligence in Inherited Epidermolysis Bullosa: Current Evidence, Challenges, and Future Directions Diagnostics (Basel), 2026.PMID 42449804
[3]Ondrušová L, Kreisingerová K, Vachtenheim J MITF Is an Essential and Functionally Multifaceted Transcription Factor in Cutaneous Melanoma Cancers (Basel), 2026.PMID 42449703
[4]Erdem S, Amparore D, Re C, Verep S, et al. What should the urologist know on the management of kidney cancer in patients with Von Hippel-Lindau syndrome? Recommendations of the European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group World J Urol, 2026.PMID 42373875
[5]Leru PM, Anton VF, Georgescu DG Severe Persistent Hypereosinophilia of Undetermined Significance: Diagnostic Challenges in Clinical Practice and Two-Year Follow-Up Rom J Intern Med, 2026.PMID 42335361
[6]Nicer J, Kania J, Sobol M, Jurkiewicz D, et al. Impact of Anatomical Subsite on Achieved Surgical Margins in Head and Neck Basal Cell Carcinoma Otolaryngol Pol, 2025.PMID 42138045
[7]Xi Y, Yao T, Zhang C, Zhuang T Effectiveness of safety care and clinical nursing pathway in patients undergoing cardiovascular intervention: a randomized controlled trial Perioper Med (Lond), 2026.PMID 42469924
[8]Marks FJ, Walters SJ, Sutton L, Jacques RM What statistical methods are more appropriate for predicting recruitment at the design stage of a randomised controlled trial? Trials, 2026.PMID 42469922