Talon noir - Skin
Talon noir tends to affect the posterior foot, the heel, the lateral foot, and the palm. Athletic events often produce shearing forces that give rise to the lesion. Basketball, lacrosse, football, soccer, and cross-country running are frequent causes of talon noir and tache noir.
The condition is asymptomatic, and because it is painless, the etiological events are often unrecognized. Because of the discoloration and generally rapid acquisition, patients may be concerned that they have an acral melanoma.
S90.30XA – Contusion of unspecified foot, initial encounter
238479007 – Talon noir
- Acral melanoma – If dyspigmentation does not resolve with superficial paring, the concern for melanoma is amplified. Lesions suspected of being even a possible melanoma should be pursued with appropriate referral to dermatology and a possible biopsy.
- Acral nevus – Also a melanocytic process that is readily appreciated on biopsy.
- Traumatic tattoo – Implantation of exogenous pigmented material, such as graphite or other carbon material, is not Hemoccult positive.
- Verruca vulgaris – Sometimes dilated and thrombosed capillaries may be seen in the center of the wart, but usually this is very punctate in nature, and other features such as interruption of skin lines indicate that a verruca is present.
- Tinea nigra – A rare fungal infection with an organism that produces its own melanin-based pigment. The fungus is readily seen on biopsy because of this endogenous pigment production.