21-Year-Old With Heel Lesion

A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week.

View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.