Pigmented oral lesion in a patient with metastatic melanoma Indian Journal of Dermatology, Venereology and Leprology PDF) Lingual melanotic macule the first case report in an adult patient Congenital Melanotic Macule of the Tongue: A Five Year Follow up Dermatology Practical & Conceptual 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.