How would you manage this large lesion on the temple?

This week, we look at an interesting case submitted by Dr Jagtaran Singh. A male patient presents for a wound review for a separate procedure, at which time this large lesion on his preauricular / temple is noticed incidentally. 

What are the differential diagnoses, and what would you do next?

Update

Following a shave biopsy, the provisional diagnosis was that of pustular dermatosis, and the patient responded well to two weeks of topical Advantan (potent corticosteroid).

Pathology report:

Follow-up photo two weeks after treatment:

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