Differential diagnosis of an oral mucosal pigmented lesion: a case of essential melanosis An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth. An oral melanotic What Caused These Multiple Hyperpigmented Macules of the Mouth? Not Cancer! Understanding Dark Spots in the Mouth, Have you noticed a dark spot on your lips, gums, or inside your mouth? Dont panic! In this video, Dr. Shifali Arora explains melanotic macules a