Basal cell carcinoma Quiz: Ace Your Exams

A 58-year-old woman presents to the primary care office for evaluation of a lesion on her nose. She states she previously had a small basal cell carcinoma in the area that was treated with cryotherapy. The skin was smooth for several years until she noticed a new lesion growing about seven months ago. She works in construction and spends long days outdoors throughout the summer. Past medical history is otherwise unremarkable, and she does not take daily medications. Pulse is 74/min, respiratory rate is 18/min, and blood pressure is 124/82 mmHg. Examination reveals a lesion on the left side of the nose as seen below. Biopsy shows aggregates of basal cells with large, hyperchromatic nuclei and minimal cytoplasm. Peripheral palisading and retraction clefts are noted. Which of the following is the most appropriate next step in management?  


^{Image reproduced from Open i}