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 A) Clinical presentation of the penile melanosis showing a large Download Scientific Diagram 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, Genital Pigmented Lesions Journal of Urological Surgery Melanocytic Lesions of the Vulva Clinical Tree