Pigmentation on the oral mucosa, hands, and feet European Journal of Internal Medicine What Caused These Multiple Hyperpigmented Macules of the Mouth? Man Concerned About a New Spot On His Lip Let's Diagnose VisualDx Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 Pigmented Lesions Springer Nature Link 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.