Derm Dx: A new growth on a woman who has had skin cancer

A 59-year-old woman presents for evaluation of a growth on her left forearm that has been present for approximately 3 months. The lesion has been increasing in size and is occasionally tender to touch. She is a cigarette smoker and admits to ample past sun and indoor ultraviolet light exposure. Her medical history includes a basal cell carcinoma that was ...