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(A) A 42-year-old female with an epidermoid cyst on the back with a punctum on the surface (arrowhead). (B) Grayscale ultrasound image shows an oval-shaped hypoechoic structure located in the upper hypodermis and dermis with a central hypoechoic band. Notice the connecting punctum (arrowhead) to the subepidermal region. In spite of the dense and irregular appearance, the posterior acoustic enhancement is conserved (arrows).
