Some guides have given multiple myeloma as the answer. However, the correct answer is eosinophilic granuloma. Punched out lesions of the skull are seen both in Eosinophilic granuloma and multiple myeloma. However, bevelled edges (double contour) is characteristic of eosinophilic granuloma due to uneven destruction of the inner and outer table of the skull. Punched out lesions of skull → Multiple myeloma Punched out lesions with bevelled edges → Eosinophilic granuloma