Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review 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. Mystery behind labial and oral melanotic macules: Clinical, dermoscopic and pathological aspects of Laugier Hunziker syndrome Pigmented Lesions of the Oral Mucosa Springer Nature Link