Histologic Findings

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.^[12]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.^[13]

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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Jakobiec FA, Bhat P, Sutula F. Winer's dilated pore of the eyelid. Ophthal Plast Reconstr Surg. 2009 Sep-Oct. 25(5):411-3. [QxMD MEDLINE Link].
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Moreira A, Menezes N, Guedes R, Tente D, Baptista A, Varela P. Dermoscopy of a dilated pore of Winer. Eur J Dermatol. 2010 Mar-Apr. 20(2):229. [QxMD MEDLINE Link].
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Cabrera R, Matus P, Coulon G, et al. Skin collision tumour and dermoscopic diagnosis of melanoma in situ and dilated pore of Winer. Australas J Dermatol. 2022 Feb. 63 (1):98-101. [QxMD MEDLINE Link].
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Lee JY, Hirsch E. Pilar sheath acanthoma. Arch Dermatol. 1987 May. 123(5):569-70. [QxMD MEDLINE Link].
Klovekorn G, Klovekorn W, Plewig G, Pinkus H. [Giant pore and hair-shaft acanthoma. Clinical and histologic diagnosis]. Hautarzt. 1983 May. 34(5):209-16. [QxMD MEDLINE Link].
Gonzalez-Guerra E, Requena L, Kutzner H. [Immunohistochemical study of calretinin in normal hair follicles and tumors with follicular differentiation]. Actas Dermosifiliogr. 2008 Jul-Aug. 99(6):456-63. [QxMD MEDLINE Link].
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Media Gallery

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 deeper part of the cavity (hematoxylin and eosin, original magnification X100).
The cavity is filled with laminated keratin (hematoxylin and eosin, original magnification X100).
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.

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Author

Alyssa Y Kim, MD Clinical Associate Professor, Department of Dermatology, Keck School of Medicine of the University of Southern California

Alyssa Y Kim, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Sigma Xi, The Scientific Research Honor Society, American College of Mohs Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Neil Shear, MD Professor and Chief of Dermatology, Professor of Medicine, Pediatrics and Pharmacology, University of Toronto Faculty of Medicine; Head of Dermatology, Sunnybrook Women's College Health Sciences Center and Women's College Hospital, Canada

Neil Shear, MD is a member of the following medical societies: Canadian Medical Association, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Canadian Dermatology Association, American Academy of Dermatology, American Society for Clinical Pharmacology and Therapeutics

Disclosure: Nothing to disclose.

Acknowledgements

Author would like to thank Dr Lawrence Marchtinger for his contribution of the microscopic slides.

Dilated Pore of Winer Workup

Histologic Findings

References

Tables

Contributor Information and Disclosures

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