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Latest update 16/06/09
Aetiology
- A benign, painless process resulting from repeated trauma or shearing forces typically associated with sports such as basketball, tennis, football, gymnastics, or marching
Key diagnostic features
- History – usually a very short history
- Age – most often found in young athletic people
- Distribution – usually the posterior or posterolateral heel, rarely the metatarsals
- Appearance
- Grouped, punctate, linear, black or blue-black macules and horizontally arranged petechiae
- The stratum corneum can be pared with a #15 blade to expose and remove the haemorrhagic material – this is in contrast with melanoma where the pigmentation is deeper and cannot be removed by pairing the stratum corneum
Additional notes
- A similar lesion called palmar petechiae or tache noire is the equivalent diagnosis on the palm and typically occurs in athletes engaged in racket sports, weight lifting, mountain climbing, gymnastics, mogul skiing, or golfing
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Figure 1 – Talon noir
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Figure 2 – Talon noir
The diagnosis can be made by paring the superficial layer of the stratum corneum, this reveals the puncta of black pigment of extravasated red cells from the dermal papilla
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