摘要： The term labial melanotic macule of the lips (MML) is used to describe a flat-pigmented lesion on the vermilion border, with an estimated prevalence of up to 3% of the population. Most MMLs are located on the lower lip and are more common in female patients. MMLs are mostly associated with hyperpigmentation of the basal keratinocytes with normal to a slightly increased density of melanocytes; an infiltrate of melanophages in the superficial dermis can also contribute to the pigmented appearance of MMLs. These benign lesions may raise concern for melanoma or may be confused with other labial pigmentary disorders. Dermoscopy is widely used for the diagnosis of pigmented and nonpigmented lesions on the skin. Reflectance confocal microscopy (RCM) is an in vivo, noninvasive imaging technique that allows horizontal optical sectioning of skin at cellular-level resolution, from the surface to a depth of about 200 μm. Although the lips are amenable for hand-held RCM examination, publications about the RCM findings in MMLs are limited. To improve the recognition of MML under RCM, we report on 3 cases of biopsy-proven MMLs.