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. Oral Malignant Melanoma Oral Cancer Foundation Information and Resources about Oral Head and Neck Cancer Oral Melanotic Macule: Symptoms and Treatment Skinsight Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management ScienceDirect