MRCP2-1010
A 75-year-old woman presented to dermatology clinic for evaluation of a skin lesion on her left cheek. The patient had recently returned to the United Kingdom after residing in southern Spain for the past 25 years. She reported the development of a lump just below her left eye over the last six months. She also recalled having an area of slightly dry and sore skin in a similar location before the emergence of the lesion, but did not seek medical attention for it. The patient denied experiencing any symptoms from the lesion, but was distressed about its unsightly appearance.
The patient’s medical history included rheumatoid arthritis, type 2 diabetes mellitus, hypertension, and intermittent episodes of gout. She had no prior dermatological conditions. Her regular medications were methotrexate 15 mg weekly, metformin 1000 mg twice daily, ramipril 2.5 mg daily, and naproxen 500 mg as needed. She denied any previous cancer treatments.
During examination, an approximately spherical nodule measuring 11 mm in diameter was observed on the patient’s cheek, 15 mm inferior to her eyelid. Crusting was noted on the surface of the nodule, but there was no hyperkeratosis, induration, or ulceration.
What is the appropriate treatment technique for the patient’s lesion?