How would you manage this lesion on the back?

In this week's case discussion, which was submitted by Dr David Stewart, we look at the case of a 75-year-old man with a past history of superficial spreading melanoma in 2017.

He presents today with a smorgasbord of pigmented skin lesions on his back. What do you think of the circled lesion? What is your preferred method of sampling suspicious pigmented lesions that are flat, and why? 

Update

Here is the pathology result.

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