Is melanoma possible after punch biopsy of dermal nevus?

Author: Dr. Bobby Buka

The questions relate to a mole that was removed by a punched biopsy. The pathology being described is a dermal nevus (a benign lesion). Apparently, the mole has returned and is growing back with symptoms of itchiness. The questions are, “Should I ask for another biopsy?” and “Should I go in earlier or wait for my six-month dermatology follow-up?”

My opinion, in this case, would be to seek a dermatology visit earlier than six months. Biopsies are challenging in that we only get a snapshot of the mole’s behavior at that particular moment. Generally, a completely benign nevus on pathology stays that way. However, not only has this mole returned, but it now has symptoms – which isn’t good. The mole’s return could portend poor melanocytic behavior; poor melanocytic behavior may indicate the malignant transformation of a previously benign mole.

With this in mind, my recommendation stands. I recommend seeking care earlier with a board-certified dermatologist. The dermatologist can perform a re-biopsy of that area and rule out atypical mole behavior.