What are the other Names for this Condition? (Also known as/Synonyms)

• Black Heel
• Pseudochromhidrosis
• Talon Noir

What is Calcaneal Petechiae? (Definition/Background Information)

• Calcaneal Petechiae is a skin condition that results from the collection of blood beneath the skin surface (epidermis) of the heel. Thus, it is also known as Black Heel. The condition is mostly observed in young sportspersons
• Calcaneal Petechiae is benign and typically asymptomatic but may be mistaken for skin cancers such as a melanoma. However, the condition is normally self-limited and tends to resolve spontaneously within 1-2 months

Who gets Calcaneal Petechiae? (Age and Sex Distribution)

• Calcaneal Petechiae is normally observed in young children, adolescents, teens, and young adults
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Calcaneal Petechiae? (Predisposing Factors)

The risk factors for Calcaneal Petechiae include:

• Sports activities such as football, tennis, basketball, and gymnastics
• Any physical activity that places repeated pressure on the heels may be a risk factor

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Calcaneal Petechiae? (Etiology)

• Calcaneal Petechiae is caused from repeat trauma to skin over the heel bone (calcaneus), usually from sports or athletic activity. The trauma may be in the form of jumping, twisting, walking, or suddenly changing directions while running
• This results in the rupture of tiny blood vessels in the region causing micro-hemorrhages (blood red spots). The red blood cells percolate into the superficial skin layers, away from the reach of phagocytic cells (certain white blood cell types that engulf dead cells in the body). Pooled blood in the region gives a dark pigmented appearance to the heel, termed Calcaneal Petechiae

What are the Signs and Symptoms of Calcaneal Petechiae?

The signs and symptoms of Calcaneal Petechiae may include:

• A sudden onset of dark spots on the heel
• The color may range from red, brown, to black
• The size and numbers of the spots may vary
• Even though a majority are observed on the heels, some may be seen on the soles, or even on the toes

No other associated signs and symptoms, such as pain, burning sensation, or discomfort, may be noted.

How is Calcaneal Petechiae Diagnosed?

A diagnosis of Calcaneal Petechiae may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation (including any history of playing sports)
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

In most cases, no tissue biopsy is required, and the healthcare provider can diagnose the condition following a visual examination and medical history assessment.

Since the condition may resemble a melanoma (a type of skin cancer), the healthcare provider may undertake a differential diagnosis to eliminate conditions presenting similar signs and symptoms. These may include:

• Acral lentiginous melanoma
• Benign melanocytic lesion
• Malignant melanocytic lesion
• Traumatic tattoo
• Viral warts

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Calcaneal Petechiae?

• Generally, there are no significant complications noted from Calcaneal Petechiae
• In some individuals, it may cause emotional stress due to concerns of a malignancy
• Recurrence of the condition on resumption of the physical/sports activity

How is Calcaneal Petechiae Treated?

• In a vast majority of individuals, no treatment is necessary for Calcaneal Petechiae, since the condition is typically self-limited
• Individuals may be advised to refrain from athletic activities/sports until a complete healing is noted

How can Calcaneal Petechiae be Prevented?

• Currently, it may not be possible to prevent Calcaneal Petechiae in all cases
• Refraining from sports activities may lower the risk for the condition, especially in young individuals

What is the Prognosis of Calcaneal Petechiae? (Outcomes/Resolutions)

The prognosis of Calcaneal Petechiae is generally good since the condition is known to resolve and heal in about 4-6 weeks.

Additional and Relevant Useful Information for Calcaneal Petechiae:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/