Oral melanoma and other pigmentations: when to biopsy? Lambertini 2018 Journal of the European Academy of Dermatology and Venereology Wiley Online Library Spotty lips. These are labial melanotic macules, kinda like freckles on the lips. They are mostly due to age and sun exposure, but sometimes they run in families and are associated with The Prevalence of Oral Pigmented Lesions among Sample of Dental Students. 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.