Omphalolith is a rare and underdiagnosed entity due to the accumulation of sebum and keratin in the umbilicus. It usually occurs in the elderly with deep and narrow umbilicus. Early recognition of omphalolith is important to prevent complications, unnecessary investigations and anxiety. We report herein two new cases of omphalolith.

The umbilicus is a remaining scar in the center of the abdomen following the removal of the umbilical cord. 1 It has different shapes. Multiple affections can raise in this area including metastasis (Mary Joseph's nodule) and endometriosis. Less commonly reported yet benign conditions are important to diagnose. Omphalolith, also known as omphalokeratolith, omphalith, or umbolith, 2 is a rare and underdiagnosed entity due to the accumulation of sebum and keratin in the umbilicus. Omphalolith is derived from two Greek words: omphalos (navel) and lithos (stone). 3 It usually occurs in the elderly with deep and narrow umbilicus. Neglect and poor corporal hygiene represent the main risk factors. Early recognition of omphalolith is important to prevent unnecessary investigations and anxiety. Delayed diagnosis may lead to complications including irritation, erosions, bleeding, pyogenic granuloma, abscess formation, cellulitis, or even peritonitis. We report herein two new cases of omphalolith and provide a comprehensive summary of its characteristics. | CASE PRESENTATION | Case 1A 28-year-old female patient presented with a dark nodule on the umbilicus. She did not report pain, bleeding, discharge, or trauma and denied recent fever or weight loss. Past medical history was consistent with Wilson's disease with cirrhosis and hyperkinetic extrapyramidal symptoms. She was entirely dependent on her mother for daily activities. Clinical examination revealed a firm, keratotic, black nodule protruding out of the umbilicus, measuring 2 × 1 cm (Figure 1A). The surrounding skin was otherwise normal. Gentle traction of the nodule using dermal forceps allowed its extraction (Figure 1B).

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Warner and Wilson-Jones syndrome (WWS), is a rare entity. We report a pediatric case of 6-year-old patient, referred to our department for recurrent nodules of the scalp following removal of capillary hemangioma. Intralesional corticosteroids infiltration was decided without recurrence until today.