<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 63-year-old woman comes to the physician because of a skin lesion on her neck for 7 months. It is neither pruritic nor painful. She has tried using over-the-counter topical medications, but none have helped. She has hypertension, hypothyroidism, and gastroesophageal reflux disease. Current medications include amlodipine, hydrochlorothiazide, levothyroxine, and pantoprazole. She is a farmer and lives with her two children. Her temperature is 37.7C 98.8F, pulse is 80min, respirations are 15min, and blood pressure is 12884 mm Hg. Examination shows a 5-mm 0.2-in nontender, indurated, nodular lesion with rolled-out edges on the anterolateral aspect of the neck. There is a central area of ulceration. There is no cervical lymphadenopathy. The lungs are clear to auscultation. Cardiac examination shows no abnormalities. In addition to dermoscopy, which of the following is the most appropriate next step in management?? A: Perform a punch biopsy of the center of the lesion, B: Perform an excisional biopsy of the entire lesion, C: Schedule external beam radiotherapy sessions, D: Perform cryotherapy on the lesion, E: Perform a wedge biopsy of the lesion and surrounding tissue,  <response>: This is a clinical vignette describing a 63-year-old woman with a chronic skin lesion on her neck. Based on the description of the lesion as a nontender, indurated nodular lesion with rolled-out edges and central ulceration, the leading differential diagnosis is a squamous cell carcinoma. The question asks about the most appropriate next step in management after dermoscopy.Choice A of performing a punch biopsy of the center of the lesion may not provide adequate sampling and could disrupt the architecture of the lesion, making histological interpretation difficult. Choice B of performing an excisional biopsy of the entire lesion is the best option, as it allows for complete histological examination of the lesional architecture and staging if it is a carcinoma.Choice C of scheduling external beam radiotherapy would be premature before a definitive diagnosis by biopsy. Choice D of cryotherapy could destroy the lesion before a diagnosis is made. Choice E of a wedge biopsy does not offer any advantage over an excisional biopsy of the whole lesion.B: Perform an excisional biopsy of the entire lesion 