COM Jan. 2008 Diagnosis UW School of Dentistry Pathology Outlines Melanotic macule 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 Oral melanotic macule" 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.