History
Most patients with dilated pore of Winer consult a dermatologist after many years of dealing with an unsightly, enlarged pore on the face. [5]
Patients with dilated pore of Winer usually have a past or present history of severe acne.
Patients report needing to repeatedly express a keratotic plug from the center of the dilated pore of Winer. The expression of this plug allows the further removal of caseous, white, soggy keratin from the deeper portion of the pore. Once the content of the dilated pore is expressed, a keratotic material similar to the original plug refills the pore within several weeks.
Physical Examination
A dilated pore of Winer usually appears as a solitary large comedo on the face, predominantly on the upper lip, cheek, or forehead. The lesion can also be found on the trunk, most commonly the back. A rare incidence involving external ear canal has also been reported. [6]
The skin surrounding the pore appears to be unchanged, with no inflammation or induration.
Complications
Manipulation of a dilated pore of Winer may lead to infection and scarring.
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Hematoxylin and eosin stain. Original magnification X40. Courtesy of Lawrence Machtinger, MD.
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Image shows an epidermal lining that is atrophic near the ostium but progressively hypertrophic and proliferative, with numerous rete ridges, in the deeper part of the cavity (hematoxylin and eosin, original magnification X100).
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The cavity is filled with laminated keratin (hematoxylin and eosin, original magnification X100).
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Dilated pore of Winer on forehead.
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Dilated pores of Winer on forehead and lateral upper labial region.
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Dilated pore of Winer on lateral upper labial region.
