Review Question - QID 109398

A 31-year-old African American woman presents to her primary care doctor for nodules on both earlobes. The nodules appeared after she got her ears pierced several months ago and she has 1 on each side. They grew in size over time and sometimes tingle but they do not cause pain. The patient is very concerned about the nodules and she is very embarrassed by them. She has a medical history of hypothyroidism and takes levothyroxine daily. She has no surgical history and her family history is notable for hypertension in her mother and bipolar disorder in her father. The patient’s temperature is 98.6°F (37.0°C), pulse is 73/min, blood pressure is 134/76 mmHg, and respirations are 13/min. Cardiopulmonary exam is unremarkable. A clinical photograph of the patient’s ear is shown in Figure A. Which of the following is the most appropriate next step in management?