American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is a classic feature of basal cell carcinoma?

1. Crusty and ulcerated surface

2. Pearly, rolled edges

3. Blackened appearance

4. Flaky and scaly texture

The correct answer is: Pearly, rolled edges

Basal cell carcinoma (BCC) is characterized by several distinct features that aid in its identification, one of the most classic being the presence of pearly, rolled edges. This specific appearance typically arises from the tumor's growth pattern, where the edges of the lesion are elevated and have a shiny, translucent quality. These rolled borders are due to the proliferation of basal cells in a nodular form, creating a characteristic nodular lesion that often has a slightly raised center. The pearly appearance is particularly notable because it helps differentiate BCC from other skin cancers and lesions, allowing for more accurate diagnosis and treatment. In many cases, these tumors may also exhibit superficial telangiectasia or small blood vessels on the surface, further enhancing their distinct appearance. Understanding this feature is essential for dermatologists and surgeons when examining patients for skin abnormalities, as early identification of BCC can lead to effective management and intervention, reducing the risk of more serious complications associated with untreated skin cancer.