Labial melanotic macule In the process of removing a Labial Melanotic Macule. A Labial Melanotic Macule is a well defined, oval, brown to black, flat patch on the central third of the lower lip, as seen 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. Labial Macules: Dark Spots on the Lip Dermatology Advisor Dental Update Malignant oral melanoma: how to spot it and how it is managed Dental Update