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. A Fast Growing Black Patch on the Upper Front Gum: Malignant Melanoma Springer Nature Link Pigmented Lesions of the Oral Cavity Pocket Dentistry Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review