Basal cell naevus syndrome is an inherited autosomal dominant genetic disorder characterised by multiple basal cell carcinomas (BCC), skeletal, neurological and opthalmological abnormalities. The treatment of choice of the often multiple and large BCC consists of a combined approach including surgery, liquid nitrogen and other topical treatment modalities. Imiquimod 5% cream is an immune-response-modifying drug with antiviral and anti-tumour activity. Recent reports have associated the immune-stimulant properties of imiquimod with the exacerbation of several autoimmune skin diseases, such as eczema, psoriasis, vitiligo and lichenoid dermatitis. Here we report a patient with basal cell naevus syndrome who developed a lichen planopilaris on the same site of the scalp, which had been previously treated with two cycles of imiquimod for multiple BCC.

Basal cell and squamous cell carcinomas are the main neoplasms of lip and perioral location. We describe different techniques of successful surgical reconstruction, including flaps or simple incision and suture. Using the latter technique satisfactory results were demonstrated, although the incision made removed more than a third of the lip, contrary to the literature. Our goal is to emphasize that the common sense and experience of the surgeon should prevail in the choice of reconstructive method. Moreover, even if the priority is complete excision of the lesion, we cannot ignore the aesthetic and functional recovery objective.