Pigmented Lesions of the Oral Cavity Pocket 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. Citalopram Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature Cureus Clinical Challenge: Dark Lesion on Lower Lip MPR Why Is There a Dark Spot on My Lip?