Dental Update Malignant oral melanoma: how to spot it and how it is managed Dental Update Spotty lips. These are labial melanotic macules, kinda like freckles on the lips. They are mostly due to age and sun exposure, but sometimes they run in families and are associated with Oral melanoma and other pigmentations: when to biopsy? Lambertini 2018 Journal of the European Academy of Dermatology and Venereology Wiley Online Library ORAL MELANOTIC MACULE (OMM) (Also called focal melanosis labial melanotic macule) A benign, localized, flat pigmented lesion of the oral mucosa Caused by a focal increase in melanin production