This was a firm tender cyst over the clavicle. Cysts over a bony prominence usually will be a little more tender due to the firmness of the bone underneath pushing against the cyst. I had an urgent care PA in the room with me, I was explaining the simplicity of a punch removal to him. It’s common to have a little extra skin at the edges of a circular cut, so a little triangular trim correction of that skin will elicit a much better cosmetic result with healing. This cyst came out resembling a shiny new pearl. The patient was very happy to have it removed. Thanks to my patient for sharing his procedure. Cyst pop. Punch excision of cyst. Dermatology Physician Assistant. Dermatology procedure. MrPopZit.