Is a Punch Biopsy Enough for a Severe Dysplastic Mole?

A punch biopsy is enough only if it is VERY small.  A severely dysplastic mole is very close to melanoma.  I usually take at least a few millimeters margin to ensure the surrounding tissue is clear.  The pathology report should show how close the lesion was to the margin.  If it was close, I would recommend re-excision.

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.