Pigmented Lesions of the Oral Mucosa Pocket Dentistry Oral Melanotic Macule MEDizzy Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management ScienceDirect Brown spots, especially on the lips, can be alarming to some. In some instances it can indicate rare oral mucosal melanoma, however in this case it was a non cancerous labial melanotic macule. AD :: Annals of Dermatology Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review