Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics Simple cryosurgical treatment of the oral melanotic macule ScienceDirect 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 melanoma and other pigmentations: when to biopsy? Lambertini 2018 Journal of the European Academy of Dermatology and Venereology Wiley Online Library 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