Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 Mystery behind labial and oral melanotic macules: Clinical, dermoscopic and pathological aspects of Laugier Hunziker syndrome Pigmented macule on the tongue of a 12 year old girl Journal of the American Academy of Dermatology 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. Oral melanotic macule Stock Image C067 2476 Science Photo Library