A 42-year-old fair-skinned woman of Irish origin presents with an abnormal skin growth that was

A 42-year-old fair-skinned woman of Irish origin presents with an abnormal skin growth that was first noted 7 years ago. On examination, a 2 x 3-cm lesion is noted over her left bicep. Which of the following historical elements most increases the suspicion that the lesion is malignant? Minimal but discernible increase in size over the past 6 months No evolution in size since onset, but mild intermittent pruritus over the last 2 years Proximal location, that is, over the bicep rather than the distal arm Presence of similar pinkish tan lesions on the sun-exposed areas including the face and hands No evolution in size since onset, but uniformly darkly pigmented color

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