Winer's dilated pore, rare presentation in the external ear canal

A 51-year-old female patient was admitted to our outpatient department with a discharging right ear of six months duration and not responding to aural toilet and topical antibiotics. Microscopic examination showed a collectio n of soggy keratin in the floor of the ear canal. Suction cleaning showed a skin defect of about 7 min in diameter. A CT scan showed rarefaction in th e bony canal. Histological diagnosis following an excision biopsy under gen eral anaesthetic showed Winer's dilated pore. Winer's dilated pore is a hai r follicle tumour arising from the pilosebaceous apparatus. Hair follicle t umours are relatively rare and their clinical appearance is commonly non-sp ecific. In spite of their non-specific features. they show a keratotic plug grossly which when removed reveals a skin defect and may show bone erosion occasionally if the underlying structure is bone. These features can be mi sinterpreted for more serious lesions such as squamous cell carcinoma or ba sal cell carcinoma of the ear canal that can lead to pursuing a more aggres sive line of management for a benign lesion. We present this rare lesion il lustrating the pathological features, differential diagnosis and management . (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.