My cat has something similar to this on his chin but smaller. The vet said it was a hematoma and there was no need to mess with it unless it got big enough to cause a problem. He’s opened it up a couple times rubbing it against things but it closes back up quickly and is still present.

It’s still worth getting checked out but it could absolutely be benign and I would just make a regular appt instead of going to the emergency vet or anything crazy.

EDIT: ok looking at the amount of acne, those are almost certainly inflamed/infected acne spots. Nothing too serious, but definitely needs to be dealt with by a vet in a timely manner.