Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review COM Dec. 2011 Diagnosis UW School of Dentistry 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. Melanotic Macules, Naevi, and Melanoma Springer Nature Link Pigmented Lesions of the Oral Mucosa Pocket Dentistry Melanotic macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight in single basal melanocytes; NO nests. More info like this in