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February 1974

Pigmented Palmar Petechiae (Black Palm)

Arch Dermatol. 1974;109(2):261. doi:10.1001/archderm.1974.01630020069019

To thEditor.—  We recently saw a young Chinese weight lifter who noted an asymptomatic petechial eruption over the volar aspects of his fingers; this eruption was identical to the petechial lesions seen in "black heel."

Report of a Case  An 18-year-old Chinese weight lifter who had not lifted weights for several months, noted considerable sliding and friction over the bar as he gripped and lifted the weights. The next day, he saw speckled, rust-red to black, linear, nonprurutic petechial lesions over the volar aspects of his fingers, corresponding to the points where his grip was strongest (Figure). Such an eruption is apparently a well-known occurrence among weight lifters, particularly in novices.

Comment  Black heel is a traumatically induced lesion originally described by Crissey and Peachey1 and others.2-5 The primary lesions are linearly arranged petechiae that usually coalesce to form asymptomatic, rusty to black macular lesions, which