A collection of resources for RACGP exams Next Gen GP Text Book live webinars AKT and KFP questions In the process of removing a Labial Melanotic Macule. A Labial Melanotic Macule is a well defined, oval, brown to black, flat patch on the central third of the lower lip, as seen Labial Lentigo (labial melanotic macule) Cancer Therapy Advisor 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.