Labial Melanotic Macule
Author: Dr Mona Elnour
Chief Editor: Dr Daniel Keith
Labial melanotic macules (LMMs) are benign pigmented lesions that usually take the shape of flat symmetrical macules with tan-brown to black color and variable size.. It is the name for a freckle arising on the lip. It is also sometimes called a labial lentigo and when multiple lesions are present, mucosal melanosis.
Macroscopic Appearance
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Usually solitary, symmetric and asymptomatic
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Measures less than 1 cm in size
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Usually found on the medial third of lower lip but can be found on the upper lip as well
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Rarely changes size and colour following development, though a history of colour change or irregular edge may be present. This can cause confusion with melanoma (very rare on lips but may occur)
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Occurs more often in women, people with fair skin and in the middle aged population though it can affect anyone.
Figure 1
Figure 2
Dermoscopic Apppearance
Documented dermoscopic features of Labial melanotic macules include:
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Background brown pigmentation
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Overlapping vessels
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Parallel lines
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Structureless black pigmentation
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Circular lines
Figure 3.
This is an annotated dermoscopic image of labial melanotic macule that contains some characteristic features:
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black circle -unstructured dark pigmentation
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red arrows- overlapping vessels
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orange arrows- parallel lines
Figure 4 .
Labial melanotic macule on Fitzpatrick skin type 2
Other skin conditions that may be confused with labial melanotic macule:
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Freckles
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Solar lentigo
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Venous hemangioma (lake)
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Junctional melanocytic nevus (a flat mole)
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Lentigo maligna
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Superficial spreading melanoma
It is worth noting that multiple lesions may indicate an alternative systemic syndrome such as:
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Peutz jeghers syndrome
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Addison disease
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Multiple lentiginosis
Treatment is not needed as it is a benign lesion however if requested some options include cryotherapy, removal by laser or intense pulsed light and excision (that leaves a scar)