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Images in medicine
Talon noir: paring can eliminate the need for a biopsy
  1. Amber B Googe1,
  2. Jennifer S Schulmeier2,
  3. Angela R Jackson2,
  4. Robert T Brodell3
  1. 1University of Mississippi School of Medicine, Jackson, Mississippi, USA
  2. 2Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
  3. 3University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
  1. Correspondence to Amber Bailey Googe, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA; abgooge{at}umc.edu

http://dx.doi.org/10.1136/postgradmedj-2014-132996

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    Introduction

    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.

    Case

    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 …

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    Footnotes

    • Contributors ABG wrote the first draft of this manuscript. JSS and RTB reviewed and approved the content of this manuscript. This case has not been presented or previously published in the literature. ARJ assisted in data gathering, case description and case background warrant.

    • Competing interests RTB received honoraria from presentations for Allergan, Galderma Laboratories, L.P. and PharmaDerm, a division of Nycomed US Inc. Consultant fees have been received from Galderma Laboratories, L.P. and Hoffmann-La Roche. Clinical trials have been performed for Genentech and Janssen Biotech, Inc.

    • Provenance and peer review Not commissioned; externally peer reviewed.