What Caused These Multiple Hyperpigmented Macules of the Mouth? Matt This patient has multiple labial melanotic macules. These are essentially freckles of the lips. These most commonly involve the lower lip. This patient had involvement of both the upper and Figure 1 from Oral melanotic macule a case report. Semantic Scholar Citalopram Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature Cureus Pigmented Lesions of the Oral Mucosa Pocket Dentistry Pathology Outlines Melanotic macule