How would you manage this growing lesion on the nose?

In this week's case discussion, submitted by Dr David Stewart, we look at the case of a 66-year-old man with no history of skin cancer who presented for an initial routine skin check in 2022, at which time two longstanding lesions were identified on his face; they appeared to be scarring.

The patient was seen by a different doctor for his skin check in 2023, and no change was reported.

Now the patient returns in 2025. The forehead lesion remains unchanged but the lesion on his nose appears significantly bigger.

What do you think of this case, and what would you do next?

2022 (left) vs 2025 (right):

Dermoscopy (2025):

Update

Here is the pathology report. What are your thoughts?

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