Question:
An elderly man has a long-standing mole over the face that is increasing in size and showing irregular borders. What is the most likely diagnosis?
An elderly man has a long-standing mole over the face that is increasing in size and showing irregular borders. What is the most likely diagnosis?
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A long-standing mole that changes slowly then grows, with irregular borders, points to the commonest melanoma subtype.
Updated On: Jun 23, 2026
- Superficial spreading melanoma
- Lentigo maligna melanoma
- Acral melanoma
- Nodular melanoma
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The Correct Option is A
Solution and Explanation
Step 1: All options are subtypes of malignant melanoma. The clue is a change in a pre-existing pigmented lesion (a mole) that is enlarging and developing irregular borders, the classic ABCDE warning signs of melanoma.
Step 2: Superficial spreading melanoma is by far the most common subtype (about 70%) and characteristically arises in a pre-existing naevus that slowly changes over years before rapid growth, which fits 'long-standing mole now increasing in size with irregular borders'. This is the recall-key answer.
Note on the discrepancy: The site (face) and the 'elderly' descriptor can also raise lentigo maligna melanoma, which classically appears as a slow-growing variegated brown macule on sun-exposed skin (face, neck, hands) of older people. Because the stem emphasises a long-standing CHANGING MOLE (naevus) with irregular borders rather than a flat macule arising on de novo sun-damaged skin, the printed key (superficial spreading melanoma) is retained.
Others: Acral melanoma affects palms and soles; nodular melanoma is a rapidly growing blue/black papule lacking a long radial-growth history.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, Pg 610.
Step 2: Superficial spreading melanoma is by far the most common subtype (about 70%) and characteristically arises in a pre-existing naevus that slowly changes over years before rapid growth, which fits 'long-standing mole now increasing in size with irregular borders'. This is the recall-key answer.
Note on the discrepancy: The site (face) and the 'elderly' descriptor can also raise lentigo maligna melanoma, which classically appears as a slow-growing variegated brown macule on sun-exposed skin (face, neck, hands) of older people. Because the stem emphasises a long-standing CHANGING MOLE (naevus) with irregular borders rather than a flat macule arising on de novo sun-damaged skin, the printed key (superficial spreading melanoma) is retained.
Others: Acral melanoma affects palms and soles; nodular melanoma is a rapidly growing blue/black papule lacking a long radial-growth history.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, Pg 610.
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