How would you manage this itchy growth on the back?

In this week's case discussion from Dr John O'Bryen, we look at a 62-year-old new patient who presents with concerns about a new, itchy growth on her mid back. 

What is your diagnosis, and what would you do next?

Update

This is a tick, which was removed with tweezers.

Incidentally, Dr O'Bryen also performed a full skin check on the patient and identified an asymptomatic, nodular BCC on her cheek which he subsequently excised.

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