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. 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 Pigmented Lesions of the Oral Mucosa Pocket Dentistry Oral Melanotic Macule MEDizzy Metastatic oral malignant melanoma transformed from pre existing pigmented lesions in mandibular gingiva: Report of an unusual case ScienceDirect Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review