A 72 year-old white female presents to you with the above lesion. She states this lesion started as a freckle and over a period of five years has continued to grow slowly and darken. She reports no other lesions similar in appearance. The diameter is approximately 3.5cm.

1. Describe the lesion.
2. What is your differential diagnosis?
3. Is this consistent with benign or malignant behavior? Support your answer.
4. What is the most likely diagnosis?
5. What is(are) your next step(s) in diagnosis/treatment?