Pigmented (Purple or Brown) Lesions in the Mouth Pigmented (Purple or Brown) Lesions in the Mouth Kazemi Oral Surgery Facialart.com 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 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. Labial melanotic macule Stock Image C057 2077 Science Photo Library