Investigate lesion with shave biopsy
This lesion has doubled in size in the past year and is not a uniform colour.
Check it with a dermatoscope. Any follicular grey circles would mandate biopsy. A shave biopsy is best as it gives a much larger area than a 3mm punch biopsy for the pathologist to examine.
Biopsy the most suspicious area seen under the dermatoscope or, in the absence of a dermatoscope, biopsy the darkest area. Several shaves can be taken and will heal without scarring. The pathology will be in the epidermis or at the dermoepidermal junction. A shave through the papillary