melanotic macule lips macule. Benign. Dark spot on labia (or lip). Analogous to lentigo simplex. Hyperpigmented basal keratinocytes & dermal melanophages. Slight ⬆️ in single basal melanocytes; NO nests. More info like this in Simple cryosurgical treatment of the

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Changes in nutritional states that prompt a metabolic shift from glucose to ketone body utilization upon prolonged fasting lead to alterations in the redox balance, including variations in cytosolic and mitochondrial NAD(P)/NAD(P)H ratios (Veech et al., 2017

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Most women can manage it with adjustments