Summary about Disease
Black heel, also known as calcaneal petechiae or "tac heel," is a benign skin condition characterized by painless black or dark brown spots on the heel. It is most commonly seen in athletes, especially those who participate in sports involving sudden stops and starts, such as basketball, tennis, and soccer. The discoloration is caused by tiny hemorrhages (broken blood vessels) within the skin due to repetitive impact.
Symptoms
The primary symptom of black heel is the appearance of asymptomatic (painless) black or dark brown macules (flat spots) or papules (small raised bumps) on the heel, typically on the posterior or posterolateral aspect. The lesions may be clustered together or appear as a single, larger patch. They do not typically itch, burn, or cause any other discomfort.
Causes
Black heel is caused by repetitive shearing forces and friction on the heel skin. This occurs commonly during athletic activities that involve:
Sudden stops and starts
Pivoting
Rapid acceleration and deceleration
Wearing poorly fitted shoes These activities cause small blood vessels to rupture within the skin of the heel, leading to the characteristic black or brown discoloration.
Medicine Used
4. Medicine used Black heel typically requires no medical treatment. It is a self-limiting condition. Medications are generally not necessary.
Is Communicable
No, black heel is not communicable. It is not caused by an infection and cannot be spread from person to person.
Precautions
While black heel is harmless, taking the following precautions can help prevent it:
Wear well-fitting athletic shoes with good cushioning.
Use cushioned insoles or heel pads to reduce impact.
Wear appropriate socks that wick away moisture.
Avoid activities that cause excessive friction on the heels, or modify activities to reduce the impact.
Ensure proper footwear for the sport or activity.
How long does an outbreak last?
Black heel typically resolves spontaneously within a few weeks to several months, depending on the level of activity and continued exposure to causative factors. If the inciting activity is reduced or stopped, the lesions will gradually fade as the blood is reabsorbed by the body.
How is it diagnosed?
Black heel is usually diagnosed clinically based on its characteristic appearance and location. A doctor will examine the heel and ask about the patient's activities. Dermoscopy (using a magnified lens to view the skin) can be helpful in confirming the diagnosis. In some cases, a biopsy may be performed to rule out other conditions, but this is rarely necessary.
Timeline of Symptoms
9. Timeline of symptoms The symptoms (black or brown spots) appear relatively quickly after the repetitive trauma occurs. The spots develop gradually over a few days or weeks of continued activity. The symptoms fade gradually over weeks to months after reducing the activity causing the friction.
Important Considerations
Although black heel is benign, it's important to rule out other conditions that can cause similar discoloration of the skin, such as:
Plantar warts: Warts can sometimes have small black dots within them, representing thrombosed capillaries.
Acral lentiginous melanoma: A rare type of skin cancer that can occur on the soles of the feet and can present as a dark spot. A dermatologist should evaluate any suspicious pigmented lesion.
Foreign body: a foreign object that has pierced the skin.