A 53-year-old woman presents with a 3×2–cm pruritic, well-circumscribed, eczematous, tender lesion that does not involve the anal verge. A punch biopsy notes intradermal infiltration of cells with large, round, eccentric nuclei, with pale vacuolated cytoplasm, which stain positive for cytokeratin 7. Workup is negative for malignancy. What is the best step in management?
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