How would you manage this lesion on the shin?

Welcome back to our first skin cancer case discussion for 2025! In this week's discussion, submitted by Dr David Stewart, we look at the case of a 60-year-old male patient who presents for a routine skin check. 

This pigmented lesion is spotted on his lower leg.

Please review the clinical and dermoscopy images below. What would you do next?

Update

Please see the pathology report below.

The patient remembers injuring his shin in the garden and thinks he might have gotten dirt in the wound. Turns out he was right!

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