What Caused These Multiple Hyperpigmented Macules of the Mouth? Pigmentation on the oral mucosa, hands, and feet European Journal of Internal Medicine 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 Oral Melanotic Macule MEDizzy Pigmented Lesions of the Oral Mucosa Pocket Dentistry