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Talon noir (black heel or calcaneal petechiae) is a benign condition that appears as an asymmetric brown-black epidermal macule on the heel or elsewhere on the plantar foot. Punctate papillary dermal haemorrhages extend into the subcorneal space following shearing forces in an area of recurrent or sudden trauma.1 These lesions can mimic melanoma and haemorrhagic viral warts, especially in cases where there is no history of trauma. If the diagnosis of talon noir is considered, simple bedside tests can obviate the need for a biopsy to exclude malignant melanoma or unnecessary treatment for a presumed viral wart.
A 34-year-old Caucasian woman presented with an asymptomatic 14 mm black-brown arrowhead-shaped macule on the calcaneal surface of her left foot (see figure 1). There was no history of trauma, ill-fitting shoes or participation in sports. Additionally, the patient denied use of anticoagulant …