Case 1:
A 28-year-old female patient presented with a dark nodule on the umbilicus. She didn’t 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 x 1 cm (Figure 1A). The surrounding skin was otherwise normal. Gentle traction of the nodule using dermal forceps allowed its extraction (Figure 1B). The underlying skin didn’t show signs of inflammation. Histopathological examination revealed laminated keratin (figure 1C). The diagnosis of omphalolith was made. Proper hygiene was advised.