Shave biopsy solves mystery
The patient said it had been slowly growing over four years. The colour is pretty uniform and light brown with just a touch of red. A punch biopsy would only sample a small part of this lesion. The best approach is to take a large shave biopsy which showed it to be a mixture of solar lentigo with early seborrhoeic keratosis formation and some small areas of pigmented solar keratosis.