Labial Melanotic Macules in Two Pediatric Patients of Chinese Descent With Atopic Dermatitis

We report two pediatric patients of Chinese descent with atopic dermatitis (AD) who developed labial melanotic macules in the absence of previous topical calcineurin inhibitor (TCI) usage. Both patients presented with multiple hyperpigmented macules on the upper and lower vermilion lips with a negative genetic workup for Peutz-Jeghers. These findings suggest labial melanotic macules may be a cutaneous manifestation of chronic eczematous dermatitis in pediatric patients, particularly those of Asian descent. Increased recognition of this phenomenon may help clinicians as they are making treatment decisions and avoid unnecessary genetic testing, thus optimizing patient care and reducing costs.