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. A cross sectional study of physiologic volar melanotic macules: Demographic, historical, clinical, and dermatoscopic features of a common yet neglected pigmentary variant in individuals with skin of color Journal of the American Oral Mucosal Melanosis IntechOpen