Use 3-0 chromic on a taper needle not a cutting needle to minimize bleeding and tissue tearing. If it is bleeds, looks like it may bleed or you have even the remotest idea that it may bleed, thoroughly cauterize it. Pre treat with fluorouracil as above and consider CO2 laser vaporization of the lesion. Close follow-up is mandatory for recurrences with this approach. I have succesfully treated several patients with topical 5-fu, also several with CO2 laser.
Mohs surgery works well for areas of ca in-situ.