Black heel D69.81

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Black heel; black heels; black palm; Black spot on the heel; calcaneal petechiae; Calcaneal petechiae; chattel noir; Heel hematoma; Heel spot; hyperkeratosis haemorrhagica; hyperkeratosis hemorrhagica; petechiae calcareous channels; tache noir

History
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Crissey, 1961

Definition
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Asymptomatic, self-limited, trauma-induced bleeding into the skin (horny layer) in the heel area, which appears as black spots over many weeks. They are differential-diagnostically eminently important for the differentiation of a malignant melanoma. Often such bleedings also occur in other mechanically strained regions of the feet (e.g. blakc toes or toe edges in football players).

Diagnosis
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Reflected light microscopically, a bizarre, splatter-like boundary and remaining red tones indicate a hematoma. If there is further uncertainty regarding the diagnosis, the horny layer can be removed horizontally in layers with a sharp scalpel. Bleeding can usually be completely eliminated in this way. If necessary, the removed material can be processed histologically (detection of blood pigment).

Differential diagnosis
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Therapy
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First of all, reliable diagnosis to exclude a malignant melanoma by reflected light microscopy, if necessary histology. Often a simple securing is achieved by flat cutting of the str. corneum with a scalpel. If necessary, a melanoma can be excluded from the horn material with the Fontana-Masson staining by iron detection.

Literature
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  1. Crissey J, Peachy J (1961) Calcaneal petechiae. Arch Dermatol 83: 501
  2. Garcia-Doval I et al (1999) Disseminated punctate intraepidermal haemorrhage: a widespread counterpart of black heel. Acta Derm Venereol 79: 403

Outgoing links (1)

Melanoma cutaneous;

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020