What Caused These Multiple Hyperpigmented Macules of the Mouth? A Fast Growing Black Patch on the Upper Front Gum: Malignant Melanoma Springer Nature Link 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 Freckle on Lip: Meaning, Causes and Is It Dangerous? (Labial Melanotic Macule) La Bouche Parfaite