Oral pigmentation in children: a diagnostic challenge Archives of Disease in Childhood Tiny brown spot on the lip? Don't ignore it. A melanotic macule is a small, well circumscribed brown to black oral lesion most commonly seen on the lower lip and a high yield ADC exam favourite. A 9 year old boy presented for evaluation of dark spots on the tongue. The family first noted these spots 5 months prior and reported that they remained stable. Can you make a diagnosis? Definition of melanocytic macules associated with Peutz Jeghers syndrome NCI Dictionary of Genetics Terms NCI COM Dec. 2011 Diagnosis UW School of Dentistry JaypeeDigital eBook Reader