This patient has multiple labial melanotic macules. These are essentially freckles of the lips. These most commonly involve the lower lip. This patient had involvement of both the upper and lower lips. Oral Melanotic Macule: Symptoms and Treatment Skinsight Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth. An oral melanotic Pigmented Lesions of the Oral Cavity Pocket Dentistry