Papulosquamous disorders: lichen planus malignant potential: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Papulosquamous disorders: lichen planus malignant potential

Sample item

A 60-year-old with long-standing erosive oral lichen planus has a persistent firm, nonhealing ulcerated plaque on the lateral tongue. What is the most appropriate next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Biopsy of the lesion

Erosive oral lichen planus carries a small risk of squamous cell carcinoma. A persistent, indurated or ulcerated area needs biopsy, not escalation of local therapy.

Option by option

  • A. Oral antifungal therapy

    An antifungal would not explain a firm nonhealing ulcer and does not address malignancy.

  • B. Increase topical steroid dose

    More steroid risks delaying the diagnosis of a possible malignancy.

  • C. Biopsy of the lesion (correct)

    Correct. A nonhealing indurated lesion in erosive lichen planus needs biopsy to exclude carcinoma.

  • D. Reassurance

    Reassurance is unsafe for a lesion with suspicious features.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Biopsy of the lesion. Erosive oral lichen planus carries a small risk of squamous cell carcinoma.

Why is "Oral antifungal therapy" not the answer?

An antifungal would not explain a firm nonhealing ulcer and does not address malignancy.

Why is "Increase topical steroid dose" not the answer?

More steroid risks delaying the diagnosis of a possible malignancy.

Why is "Reassurance" not the answer?

Reassurance is unsafe for a lesion with suspicious features.

What concept does this question test?

It tests Papulosquamous disorders: lichen planus malignant potential in Dermatology. A persistent, indurated or ulcerated area needs biopsy, not escalation of local therapy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Papulosquamous disorders: lichen planus malignant potential?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.