A 63-year-old man asks if you can get rid of a wa from his back that catches on his clothes and bleeds on occasion. He thinks it has been there for only a couple of months. The lesion is shown below. Which one of the following would be the single most appropriate treatment for this lesion?

Although most likely a wa, irregular appearance, rapid growth, and history of bleeding raise a possible diagnosis of squamous cell carcinoma (SCC). Excision biopsy with histology - most appropriate treatment. Cryotherapy or cautery does not provide tissue for histology. Curettage is an option with tissue sent for histology but fuher excision would be necessary if SCC is confirmed.