Pigmented Lesions of the Oral Mucosa Pocket Dentistry What Caused These Multiple Hyperpigmented Macules of the Mouth? Labial melanotic macule Brown spots, especially on the lips, can be alarming to some. In some instances it can indicate rare oral mucosal melanoma, however in this case it was a non cancerous labial melanotic macule. Oral melanoma and other pigmentations: when to biopsy? Lambertini 2018 Journal of the European Academy of Dermatology and Venereology Wiley Online Library Oral Melanotic Macule: Symptoms and Treatment Skinsight