How would you manage this dark lesion on the back?

In this week's case discussion, from Dr John O'Bryen, we look at a 56-year-old man who presents for his annual skin check. His wife comments on this standout, black lesion on his back.

The dermoscopy photo is taken in non-contact, polarised mode.

What is your diagnosis, and what would you do next?

Update

A shave removal of the lesion reports seborrhoeic keratosis.

A contact, non-polarised dermoscopy may have shown white clods and helped support the diagnosis. However, sometimes it is better to remove and test lesions like this to reassure our patients. If I was suspicious for melanoma I would have done an excisional biopsy. - Dr John O'Bryen

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