Nachira et al., (2014) report a BHD case study from Italy where diagnosis was proposed based on a presentation of bilateral pneumothoraces and the presence of multiple fibrofolliculomas on the face. The patient also reported previous excision of a chromophobe renal tumour. Nachira et al. discuss the need to include BHD in the differential diagnosis of recurrent pneumothoraces, especially in patients with a family history of the “diagnostic triad”. Additional mention is given to the use of pleurodesis as a treatment to prevent recurrence of pneumothoraces in BHD patients.