Vulvar Melanotic Macules DoveMed Melanocytic Lesions of the Vulva Clinical Tree Melanotic macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight in single basal melanocytes; NO nests. More info like this in Genital Pigmented Lesions Journal of Urological Surgery Not every dark spot 'down there' is dangerous but some can be Many women notice small brown or black spots on the vulva called melanotic macules. These are usually harmless, flat,