05 May 03 Eng What Caused These Multiple Hyperpigmented Macules of the Mouth? 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 COM Dec. 2011 Diagnosis UW School of Dentistry Pigmented Lesions Springer Nature Link