All suspicious pigmented lesions should be biopsied.
Excisional biopsy is preferred.
An incisional biopsy for extensive lesions such as lentigo maligna melanoma is acceptable. Initial evaluation may include a chest radiograph and a complete blood count. Other investigations are dependent on signs and symptoms. So if a patient complains of a new onset headache or motor weakness, a head CT may be clinically indicated. The presence of lymphadenopathy generally requires intervention such as complete lymph node dissection, fine needle aspiration, or lymph node biopsy.