How would you manage this lesion on the chest?

In this week's discussion, we revisit a case from Dr David Stewart. An 87-year-old man who presented to his dermatologist with a lesion on his chest.

The dermatologist recommended for the lesion to be removed, but the patient put off treatment. Now he presents nine months later to his GP. The lesion has grown significantly.

What do you think of it?

Update 1

Here is the pathology result. What next?

Update 2

Here are some follow-up photos provided by Dr David Stewart.

1. How the lesion looked after the shave biopsy when the patient returned for his excision
2. Marking up for a Mercedes excision
3. The post-op result

	Would you like to obtain advice or share your experience with your colleagues and Dr Terry Harvey in the weekly blog case discussion?  Participate with your cases so that we can learn together! Submit your case here or send details to admin@healthcert.com
Contributing to the Skin Cancer Case Discussion Blog helps meet your annual Performance Review CPD requirement!
Submit your own case* = 1 CPD hour (Performance Review) *Case must be published on the blog to qualify.	Comment/engage with colleagues’ cases  = 0.5 CPD hours (Performance Review)
How to claim your CPD hours If you interact with this case or submit your own case, you can Quick Log your CPD hours with the RACGP via the usual self-submission process. You will be asked to reflect on what you have learned, and you will require proof you interacted with the blog; a screenshot will suffice.