A 29-Year-Old Man Comes to the Physician for a Routine

A 29-year-old man comes to the physician for a routine preventive examination.  He is currently feeling well but states that he has always had "some dark spots" on his back.  The patient has no family history of heart disease or cancer.  He does not spend much time outdoors and had no prior sunburn.  He does not smoke.  Physical examination shows many pigmented lesions on his back as shown below. The following 8-mm lesion is seen on close skin inspection.
Which of the following is the best next step in the management of this patient's skin lesion?

A) Assessment of glycemic control and insulin resistance
B) Excisional biopsy
C) Incisional biopsy
D) Photographic documentation and comparison in 6-12 months
E) Sentinel lymph node biopsy

Correct Answer:

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