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black heel; calcaneal petechiae
Etiology:
- intradermal hemorrhages caused by sheer friction against a shoe
Epidemiology:
- black heel often occurs in athletes, such as runners
Pathology:
- intraepidermal extravasation of erythrocytes in the epidermis of the heel
Clinical manifestations:
- lesions resolve spontaneously with discontinuation of the causative activity
Differential diagnosis:
- plantar warts
- can mimic the thrombosed capillaries of plantar warts
- black heel lesions do not obscure dermatoglyphics & can be removed by scraping
- this differentiates them from plantar warts.
General
petechiae
References
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022