A dilated pore of Winer is a hair structure anomaly that appears as an enlarged solitary comedo. Most commonly, it appears on the face of a middle-aged person. This condition is not associated with acne vulgaris. See the images below.
Dilated pore of Winer on forehead.
Dilated pores of Winer on forehead and lateral upper labial region.
Dilated pore of Winer on lateral upper labial region.
A dilated pore of Winer is a tumor of the intraepidermal follicle and infundibulum of a pilosebaceous apparatus. An immunohistochemical study using monoclonal antibodies against cytokeratins and involucrin confirmed differentiation toward the infundibulum and partly toward the isthmus.
Most cases of dilated pore of Winer are reported in older adults in both the American and European literature.
Death is not associated with a dilated pore of Winer. One case of trichoid basal cell carcinoma in a dilated pore has been reported. More commonly, chronic manipulation and expression of the keratotic plug from inside the pore may lead to inflammation and infection of the surrounding tissue.
Most cases of dilated pore of Winer have been reported in white males.
Although dilated pores are found in both sexes, they appear to occur in men more often than in women.
Most cases of dilated pore of Winer are diagnosed in individuals older than 40 years; however, many individuals report that they have had the lesions for many decades, usually starting when they are aged 20-60 years.
Dermoscopic examination shows a pinkish nodule with peripheral vessels in a regular pattern. The individual vessels at the periphery of the lesion extend towards the center. The size of the vessels decreases with every progressive branching. The center of the lesion reveals a dilated ostium filled with terminal hairs.
Histologic examination of a biopsy specimen from the lesion is the only way to make a definitive diagnosis.
A dilated follicular infundibulum extends deep into the dermis and, at times, into the subcutaneous tissue. The cavity is lined by the epidermis, which is atrophic near the follicular ostium. The epidermis is hypertrophic and proliferative in the deeper portion of the invagination where the numerous rete ridges project into the surrounding stroma. The cavity is filled with laminated keratin. Vellus hair follicles and small sebaceous lobules may be attached to the lower portion of the infundibulum. Gonzalez-Guerra et al reported in 2008 that cutaneous adnexal tumors of the hair follicle can be identified using immunohistochemistry studies for calretinin, with differentiation towards cells of the outer root sheath.
Hematoxylin and eosin stain. Original magnification X40. Courtesy of Lawrence Machtinger, MD.
Image shows an epidermal lining that is atrophic near the ostium but progressively hypertrophic and proliferative, with numerous rete ridges, in the d....
The cavity is filled with laminated keratin (hematoxylin and eosin, original magnification X100).