Oral Melanotic Macule: Symptoms and Treatment Skinsight 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. Pigmented Lesions of the Oral Mucosa Springer Nature Link Congenital lingual melanotic macule: an underreported entity? European Journal of Pediatric Dermatology