Dermatology: Practical and Conceptual


Dermatology Practical & Conceptual

Image Letter  |  Dermatol Pract Concept. 2021;11(3): e2021021 1

Large Pore Basal Cell Carcinoma: A Case Report
Ana Inés Lösch1, Virginia Mariana González1, Félix Alberto Vigovich2, Margarita Larralde1

1 Dermatology Department, Hospital Alemán, Buenos Aires, Argentina.

2 Histopathology Department, Hospital Alemán, Buenos Aires, Argentina

Key words: basal cell carcinoma, large pore basal cell carcinoma, dermoscopy, pore of Winer, epidermal appendageal tumors

Citation: Lösch AI, González VM, Vigovich FA, Larralde M. Large pore basal cell carcinoma: a case report.  
Dermatol Pract Concept. 2021;11(3): e2021021. DOI: https://doi.org/10.5826/dpc.1103a21.

Accepted: September 11, 2020; Published: July 8, 2021

Copyright: ©2021 Lösch et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License BY-
NC-4.0, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and 
source are credited

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication

Corresponding author: Lösch Ana Inés, MD. Dermatology Department, Hospital Alemán, Buenos Aires, Argentina. 1640 Pueyrredón Ave., 
Ciudad de Buenos Aires, Argentina. Email: anaineslosch@hotmail.com

Case Presentation

A 75-year-old-male with a history of multiple basal cell carci-

nomas visited our clinic for aesthetic treatment of a large pore 

in the nasal tip that he noticed 4 months ago. Following pres-

sure application, keratinous material emerged from the center 

of the lesion (Figure 1A). Dermoscopy showed a central dilated 

pore surrounded by a whitish pink poorly circumscribed area 

with in focus branched vessels. Grey pigmentation and yellow-

ish-white scales were also seen around the central pore (Figure 

1B). A punch biopsy was performed and was consistent with 

large pore basal cell carcinoma (BCC) (Figure 1, C and D). The 

patient underwent Mohs surgery and plastic reconstruction.

Teaching Point

Pore-like or large pore basal cell carcinoma is an atypical and 

very infrequent clinical presentation of BCC. Both dilated 

pores and BCC, are tumors of follicular origin. Some authors 

have postulated that the same stem cell could originate them, 

so they may coexist in a single cutaneous lesion. Dermatol-

ogists must take this into account when making differential 

diagnoses of solitary enlarged pores, especially when localized 

on the face. Dermoscopy is an excellent tool for its recogni-

tion [1, 2].



2 Image Letter  |  Dermatol Pract Concept. 2021;11(3): e2021021

References
1. Benedetto AV, Benedetto EA, Griffin TD. Basal cell carcinoma pre-

senting as a large pore. J Am Acad Dermatol. 2002; 47:727-32. 

DOI: 10.1067/mjd.2002.124075. PMID: 12399765

2. Carlson-Sweet KL, Weigand DA, MacFarlane DF. Trichoid bas-

al cell carcinoma found in a dilated pore on the nose. Dermatol 

Surg. 2000; 26:874-6. DOI: 10.1046/j.1524-4725.2000.00083.x. 

PMID: 10971562

Figure 1. Large pore in the nasal tip. (A) Clinical image. (B) Dermoscopy reveals a large pore surrounded by a whitish 

pink poorly circumscribed area (*) with superficial branched vessels (black arrow) and grey pigmentation (blue arrow).  

(C) Histopathology (H&E, x40). Dilated pilar infundibulum lined with a squamous epithelium. (D) (H&E x100) Prolifera-

tion of basaloid neoplasic cells with stromal retraction sectors (white arrow) underlying the squamous epithelium and focus 

of calcification (black arrow).