Endogenous Pigmented Lesions of the Oral Cavity Malignant Melanoma & Differentials Explained Dental Update Malignant oral melanoma: how to spot it and how it is managed Dental Update 30 year old man with painless hyperpigmentation on buccal mucosa of a few months duration. Relatively stable in terms of size. Mirror lesion on other cheek. No history of trauma or smoking. 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