What are the other Names for this Condition (Also known as/Synonyms)

• Labial Lentigo
• Labial Melanosis
• Melanotic Macules of the Lip

What is Labial Melanotic Macules? (Definition/Background Information)

• Melanotic macules are dark spots that may be observed on the skin, mucus membranes of the mouth, genitalia, and in the nails. Melanotic macules are benign lesions and no malignant transformation to a melanoma has been recorded
• A macule indicates the presence of a flat, distinct, discolored area of skin less than 1 cm wide. A macule usually does not involve any change in the thickness or texture of the affected skin
• Labial Melanotic Macules are observed on the lips, especially in the lower lip. It is a commonly observed skin condition in children and adults
• The presence of numerous melanotic macules on the body may be associated with a variety of syndromes including Carney complex, Peutz-Jeghers syndrome, and LEOPARD syndrome. In such cases, the cause of the condition may be genetically-influenced
• In most cases, Labial Melanotic Macules are asymptomatic and do not present any significant signs and symptoms. No complications are typically associated with these lesions; although in some cases, the macules may be confused for melanoma in situ (a precancerous skin condition)
• In a majority, no treatment of Labial Melanotic Macules may be necessary and the healthcare provider may undertake a ‘wait and watch’ approach
• In case treatment is necessary, it may be provided and the prognosis is excellent. However, the overall prognosis may depend upon the severity of the signs and symptoms of any underlying disorder (if any present)

Who gets Labial Melanotic Macules? (Age and Sex Distribution)

• Labial Melanotic Macules is a common presentation; about 3% of the population may have melanotic macules of the oral cavity (mouth)
• It can be seen in both children and adults
• When it is seen on the lower lip, a female predominance is observed
• There is no racial or ethnic predilection for this skin condition

What are the Risk Factors for Labial Melanotic Macules? (Predisposing Factors)

Presently, there are no risk factors identified for solitary Labial Melanotic Macule. In the case of multiple melanotic macules, the following rare genetic conditions may be involved:

• Laugier-Hunziker syndrome
• Carney complex
• LEOPARD syndrome
• Peutz-Jeghers syndrome
• LAMB syndrome
• NAME syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Labial Melanotic Macules?

The exact cause of Labial Melanotic Macules is not well-understood. 

• When numerous macules are observed, they may be found in association with certain genetic conditions or syndromes
• When these macules occur in isolation, they are usually sporadic and no associated conditions are observed

The skin condition is not infectious and does not spread from one individual to another through contact.

What are the Signs and Symptoms of Labial Melanotic Macules?

The clinical signs and symptoms of Labial Melanotic Macules include the following:

• The presence of pigmented skin lesions/spots on the lips (lower lips usually); the lesions may be seen in the oral mucosa and tongue too
• They form discolored flat and asymmetric patches less than 1 cm in size
• The color of the macules may be uniform or non-uniform; the color may vary from shades of dark brown to black
• The macules usually single; multiple lesions may also be seen
• The borders of the lesions are usually irregular
• When Laugier-Hunziker syndrome is present, the melanotic macules may involve the nail units too
• The underlying skin or mucosal surface usually remains unaffected; no change in the thickness or texture of the skin is typically observed
• The macules may be present unchanged for many years and some are indistinguishable from a melanoma (s skin cancer type)

How is Labial Melanotic Macules Diagnosed?

The diagnosis of Labial Melanotic Macules may involve the following procedures:

• The diagnosis is usually made by a complete physical (oral) examination and evaluation of medical history and family history
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is performed to rule out other similar conditions

Note: A skin biopsy is not usually necessary, but may be performed if the healthcare provider suspects a malignancy such as a melanoma in situ.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Labial Melanotic Macules?

The complications of Labial Melanotic Macules may include the following:

• The longstanding skin patches can cause emotional stress and cosmetic concerns in some individuals
• The appearance of the pigmented macules may induce a fear of melanoma (which is a type of skin cancer)
• Complications that arise from an underlying genetic condition/syndrome

How is Labial Melanotic Macules Treated?

The treatment of Labial Melanotic Macules may include the following:

• The healthcare provider may choose to regularly observe the benign lesions; a “wait and watch” approach may be followed, once a diagnosis of a melanotic macule is established. In such cases, no treatment is generally required
• If required, a surgical excision and complete removal of the macule, primarily to address cosmetic issues may be performed
• Treatment of the underlying associated genetic disorder, if any
• Follow-up care with regular screening and check-ups are encouraged

How can Labial Melanotic Macules be Prevented?

There is currently no effective means of prevention of Labial Melanotic Macules, because the cause of this condition is unknown.

What is the Prognosis of Labial Melanotic Macules? (Outcomes/Resolutions)

• The prognosis of Labial Melanotic Macules is typically excellent with adequate treatment. No malignant transformations of these macules have been recorded
• In some cases, no treatment may be necessary and the healthcare provider may choose to observe these skin lesions (wait and watch approach)
• If these lesions are associated with any genetic disorders, then the overall prognosis depends upon the severity of the signs and symptoms of the disorder

Additional and Relevant Useful Information for Labial Melanotic Macules:

• Carney complex comprises a combination of medical conditions that includes multiple tumors, such as myxomas, schwannomas, endocrine disorders, and pigmented skin conditions

Please read more on Carney complex by visiting the following link below:

http://www.dovemed.com/diseases-conditions/carney-complex-cnc/