PDF] Penile Melanosis Associated with Lichen Sclerosus et Atrophicus: First Description in the Medical Literature Semantic Scholar 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, Atypical Pigmented Penile Macules Labial Lentigo (labial melanotic macule) Cancer Therapy Advisor Melanosis and Lentiginosis (benign) Vulvovaginal Disorders