Which statement is most characteristic of basal cell carcinoma?

• A. A raised lesion with pearly borders
• B. A flat pigmented macule
• C. An ulcerated irregular blue lesion
• D. A rapidly enlarging mottled patch

Answer: (A)

Basal cell carcinoma most often shows up as a raised, pearly (translucent) nodule on sun-exposed skin, frequently with visible tiny blood vessels (telangiectasias) and a rolled border; central ulceration can give a crater-like center. That pearly, raised appearance is the hallmark that fits this condition best. The other descriptions point to different skin cancers: a flat pigmented macule suggests a flat pigmented lesion such as lentigo or melanoma in situ; an ulcerated irregular blue lesion suggests melanoma with pigmentation; a rapidly enlarging mottled patch is more typical of melanoma or other aggressive skin neoplasms.