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.

More general terms

• petechiae