Infundibulocystic basal cell carcinoma was described in 1987 as a new type of basal cell carcinoma with follicular differentiation. A great controversy followed this description, mainly about the malignant or benign character of this neoplasm and the distinction from other tumors with follicular differentiation. We present two new cases of this neoplasm: the first one had the typical features of this entity, except for the absence of stroma; the second one showed in the deep portion basaloid nodules similar to those of a nodular basal cell carcinoma. We review the criteria adduced to establish the malignant character of this neoplasm and conclude that both the nosology and biological behavior of this neoplasm with follicular differentiation remain to be determined.

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The management of angio-oedema is quite complicated because of the frequent poor response to usual treatments, including H1 antihistamines, systemic corticosteroids, immunosuppressant drugs, antileucotriene drugs or tranexamic acid. Omalizumab, an anti-immunoglobulin (Ig)-E antibody, has shown good resuts in chronic spontaneous urticaria, and might also be a good option for angio-oedema. To our knowledge, there have been eight relevant case reports published in the English literature. We report two further cases (a 55-year-old man and a 36-year-old woman) with severe chronic recurrent angio-oedema affecting the face, pharynx, hands, feet and hips. Both patients were refractory to H1 antihistamines, systemic corticosteroids and tranexamic acid. We decided to start with subcutaneous omalizumab 375 mg every other week and tapering doses up to 375 mg every 4 weeks. Both patients showed a very good response to the therapy, with clinical improvement in the first week. This response remained stable more than 3 years later.

Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids.Case reportA sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis.DiscussionWe describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.

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