Pigmented macular 
lip lesion

An active-duty airman aged 30 years presented for an assessment of intermittent abdominal cramps. Physical examination revealed five macular, brown, hyperpigmented lesions on his lower lip. The first lesion appeared two years earlier and remained asymptomatic except for a slight increase in size. The four similar lesions developed at different stages during this time period.

The man is a nonsmoker ...