Review Question - QID 212546

A 70-year-old woman is brought to her primary care physician by her son for a skin lesion. He states that his mother noticed the lesion on her face 5 months ago. They both thought that it was a pimple. It started enlarging in size, and she had just been using make-up to cover it. She denies pain, bleeding, or pruritis. When the patient’s son came to visit her, he felt that it was significantly bigger than when he first saw it. The patient’s medical history includes atrial fibrillation, congestive heart failure, and osteoarthritis. She takes captopril, carvedilol, spironolactone, furosemide, warfarin, and acetaminophen as needed. She lives on her own and is independent, including paying for her pills and grocery shopping. Upon physical examination, there is a skin lesion on the patent’s right cheek, as shown in Figure A. Which of the following should be the next step in management?