Which combination of features favors melanoma over a nevus?

• A. Diameter >6 mm and depth >2 mm, with no drusen or halo
• B. Flat, slate gray lesion 1-5 mm with drusen and halo
• C. Large orange pigment with halos
• D. Tiny lesion with drusen and shallow depth

Answer: (A)

A key idea is that melanoma risk rises with both size and thickness, while features like drusen or a halo around a pigmented lesion tend to point toward a benign nevus or a regressing nevus. Here, the combination of a diameter greater than 6 mm and a depth greater than 2 mm indicates a lesion that is both large and relatively thick, which is more compatible with melanoma than with a benign nevus. The absence of drusen or halo removes those benign-appearing signs, further tipping the balance toward malignancy.

The other scenarios describe smaller lesions or those with halo or drusen, which are characteristic of benign nevi or regressing processes, not melanoma. So the feature pattern of large size plus significant depth without halo or drusen best supports melanoma over nevus.