In both algorithms, the same 26 lesions were categorized into the group not showing typical benign dermoscopic patterns and larger than 7 mm in diameter. Biopsy was performed in 19 of the 26 lesions, and the remaining 7 lesions were not biopsied because of refusal by patients or physically or psychologically complicated conditions of the patients. Of the biopsied 19 lesions, 8 lesions were histopathologically diagnosed as acral melanoma, In the original algorithm, 148 lesions were categorized into the group to be followed up. In contrast, in the revised algorithm, 101 lesions of the 148 lesions (68.2%) were categorized into the group without need of further follow-up, and the remaining 47 lesions (31.8%) were categorized into the group to be followed up periodically. In actuality, biopsy was performed in 28 of the 148 lesions categorized into the follow-up group in the original algorithm, and all of them were melanocytic nevi. The remaining 120 lesions were followed up for a median of 48 months (approximate follow-up range, 21-68 months). No significant changes in dermoscopic features were observed in any of these 120 lesions during the follow-up period.