How would you treat this lesion on the right hand?

This week we revisit a case submitted by Dr Robert Teunisse, featuring a firm, elevated lesion on the right hand of a 48-year-old male patient. There is a basal cell carcinoma excision adjacent.

What do you think? What would you do next?

Update
Here is the pathology result. The patient was referred to a local melanoma surgeon who performed a wide local excision + lymph nodes from elbow and axilla.

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