Advanced Health Assessment Practice Exam

What is the most likely diagnosis for a patient with a flattened papule that is the same color as the skin and covered with dry scale?

1. Basal cell carcinoma

2. Seborrheic keratosis

3. Actinic keratosis

4. Squamous cell carcinoma

The correct answer is: Actinic keratosis

The diagnosis of actinic keratosis is particularly fitting in this scenario due to the characteristics described. Actinic keratosis typically presents as a flattened papule that is the same color as the surrounding skin, often with a dry, scaly texture. It arises as a result of prolonged sun exposure and is often found on sun-damaged skin, particularly on areas like the face, ears, neck, scalp, and backs of the hands. The dry scale noted in the question is a hallmark of actinic keratosis, where keratin buildup leads to scaly patches. This condition is considered precancerous, as it can progress to squamous cell carcinoma if left untreated. In contrast, basal cell carcinoma usually presents as a pearly or waxy bump, seborrheic keratosis has a velvety or "stuck-on" appearance, and squamous cell carcinoma often presents as a firm, red nodule or a flat lesion with a scaly crust. Therefore, the specific description of a flattened, skin-colored papule with dry scaling aligns closely with actinic keratosis, leading to this as the most likely diagnosis.