Oral melanotic macule" Lip melanotic macula Hoogstra Medical Centers A flat and oval shaped melanotic macule on the vermilion border of the Download Scientific Diagram Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 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.