Pathology Outlines Melanotic macule Clinician's Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva: The Dermatologist's View Sand 2017 International Scholarly Research Notices Wiley Online Library Melanotic macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight in single basal melanocytes; NO nests. More info like this in Melanocytic nevi Clinical Tree Not every dark spot 'down there' is dangerous but some can be Many women notice small brown or black spots on the vulva called melanotic macules. These are usually harmless, flat, Penile Melanotic Macules DoveMed