Very large Dilated pore of winer, filled with old dead skin cells that have oxidized on the surface. This one was actually a shallow cyst with a cyst wall extending down into the adipose tissue. I was initially going to just cauterize the base, however once I removed the thick plug I could visualize the deeper pocket with cyst contents. I decided to punch the small sac out and close the hole left behind with sutures. Thanks to my patient for sharing her procedure. Large DPOW. Large blackhead. Follicular cyst. Dermatology Physician Assistant. Dermatology procedure. Punch excision. Simple interrupted sutures. MrPopZit.