Is a Punch Biopsy Enough for a Dysplastic Nervus with Moderate Atypia?

While this is benign pathology there is a description of atypical cells.  Rexcision to obtain clear margins would be recommended to be safe. Ongoing monitoring of moles is advised.

Moderately dysplastic nevi (moles) should be excised. If the margins were clear, the punch biopsy would have been enough. But since the lesion extends to the margins, a simple re-excision should be performed.

In my practice, I routinely excise (cutting with sutures) a lesion (or the biopsy site of where the lesion was sampled)  that histologically displays "moderate atypia" and "extends to the peripheral specimen margin." The excision should be conservative as to spare healthy tissue but adequate so as to achieve clear margins.  Once a patient has a "dysplastic" or "atypical" mole, I recommend full body skin exams twice yearly (every 6 months). At this time, I suggest you consult with a well-trained, board-certified dermatologist to further treat this lesion and to do your twice yearly skin exams with. 

Although biologically benign, most doctors agree that it is best to remove dysplastic nevi. A punch biopsy is only used for diagnosis but not treatement unless the lesion is so tiny that it is completely removed with the punch and does not come to the margin.

We routinely excise nevi with moderate or severe atypia in our practice until there are clear margins.  If we get a report back that states the lesion goes to the edge of the specimen, we would re-excise it.