What is the most appropriate clinical management for a changing mole suspected to be melanoma?

Excisional surgery is the most appropriate clinical management for a changing mole suspected to be melanoma. This approach is crucial as melanoma is a type of skin cancer that can be aggressive and has a propensity to metastasize. The goal of excisional surgery is to fully remove the mole along with a margin of surrounding healthy tissue to ensure that all cancerous cells are excised. This not only helps in making a definitive diagnosis by allowing for proper histological examination, but also significantly reduces the risk of recurrence and metastasis.

For a suspected melanoma, it is essential to act quickly and decisively to prevent the potential spread of the disease. Cryosurgery is not suitable, as it may not completely remove the mole and could lead to missed diagnoses of melanoma. Topical retinoids and topical chemotherapy are typically reserved for other skin conditions or superficial skin cancers, and they are not appropriate for managing melanoma, especially when surgical intervention is warranted for effective treatment.