A 58-year-old man who works as a landscaper presents with a pigmented lesion on his upper back that his wife noticed 4 months ago. It has enlarged and darkened since then and is occasionally itchy. He has fair skin that burns easily and recalls several blistering sunburns in his youth. On examination, the lesion is 9 mm in diameter, asymmetric, with a notched irregular border and several shades of brown and black. It looks different from his other moles. There are no palpable cervical, axillary or inguinal lymph nodes.
| Heart rate | 72/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 128/78 mm Hg |
Question 1 of 6
Which one of the following is the most appropriate next step in the management of this lesion?
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