Melanotic macule MEDizzy 56M with an asymptomatic, darkly pigmented lesion on the attached gingiva of the maxilla, an irregularly shaped macule with varied pigmentation, including shades of black, brown, and gray. Brendan Gallagher, DDS Pigmented (Purple or Brown) Lesions in the Mouth Pigmented (Purple or Brown) Lesions in the Mouth Kazemi Oral Surgery Facialart.com An oral melanotic macule is a harmless dark spot found on the lip, most often the lower lip, or inside the mouth, either on the gums, inside the cheek, or on the roof of the mouth. An oral melanotic Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review