A Rare Case of Primary Mucosal Melanoma of the Palate ClinMed International Library Clinical Medical Reviews and Case Reports Pigmented Oral Lesions: Clues to Identifying the Potentially Malignant Consultant360 dermoscopy: A pigmented labial lesion Oral Melanotic Macule MEDizzy 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.