Is a Punch Biopsy Enough for a Severe Dysplastic Mole?

Atypical Nevi (moles) that are severely or moderately atypical need to be completely excised both clinically and microscopically.  Midly atypical nevi (sometimes called a Clark's Nevus) are considered, by most dermatologist, to be a variant of normal, and complete re-excision is not necessary.

A Biopsy Punch is really a tool that is generally used to obtain a diagnosis (biopsy) but this tool may also be used for treatment (excision).  Some Biopsy punches are large enough to encircle the entire lesion along with the necessary margin for clearance.  If the lesion is completely removed with adequate microscopic margins, you should be fine.

One thing to keep in mind-- the science of pigmented lesions is imperfect.  There is great debate within the scientific community about exactly what an atypical mole really means, about the necessity to treat and what the proper treatment is.   Be sure to consult with a respected, Board Certified Dermatologist that you trust and have a good rapport.  This is the best way to obtain your best care.

 

A punch biopsy can be used as a tool for obtaining clear margins around a lesion depending on the size of the lesion and the size of the punch biopsy instrument. A shave biopsy is generally not going to obtain any sort of clear margins. The difference between 3 mm and 5 mm margins is very small and is going to be difficult to determine after excision/biopsy. Following up with your dermatologist and checking the area regularly would probably be the recommended course of action, but be sure to follow your doctor's advice.
All the best,

The lesion needs to be excised such that there are microsopically clear margins. Punch biopsy or elliptical excision are both acceptable methods of excision as long as the margins are clear.