The image shows a large, raised and swollen area across the upper back and shoulder, with numerous dark, crater-like openings resembling blackheads or enlarged pores. The unusual size and density make the image difficult to identify from appearance alone, especially because similar images circulating online may sometimes be digitally altered, staged or artificially created.
One possibility is a severe form of comedonal or nodulocystic acne, in which pores and hair follicles become blocked and inflamed. Other possibilities can include unusual clusters of open comedones or other enlarged skin lesions. Conditions such as chloracne can also produce prominent follicular lesions, although an image alone cannot establish whether that is what is present.
Because the appearance is so unusual, attempting to squeeze, puncture or extract the openings at home could cause infection, bleeding and permanent scarring. If something similar occurs on a real person’s skin, a dermatologist should examine it and determine the underlying cause before treatment is attempted.