A 58-year-old man presents for evaluation of a changing mole on his upper back. He first noticed it 8 months ago, and his spouse reports it has become larger and darker. He has a history of intermittent intense sun exposure and multiple blistering sunburns as a teenager. Physical exam shows a 1.3-cm asymmetric, irregularly bordered, variegated brown-black macule with a small raised nodular component. No palpable lymphadenopathy is present. A punch biopsy is performed and shows malignant melanocytes with pagetoid spread. Which of the following is the most appropriate definitive management for this lesion?

(A) Excision with wide margins (B) Observation with periodic skin exams only (C) High-potency topical corticosteroids applied twice daily for 2 weeks (D) Reassurance; lesion is a benign port-wine stain (E) Surgical excision plus evaluation for angiosarcoma due to radiation-associated lymphedema