Background and Clinical Significance: Primary Cutaneous Cribriform Apocrine Carcinoma (PCCAC) is a rare, inert low-grade cutaneous malignancy that is diagnosed on histopathologic assessment. PCCAC usually presents in middle-aged adults as a solitary, subcutaneous nodule on the extremities. Characterized by anastomosing tubules and solid/cribriform nests of atypical epithelial cells generating a sieve-like display, the tumor is a histopathological variant of apocrine metaplasia of the skin. PCCAC also follows characteristic staining patterns. It is important to distinguish PCCAC from other similar histological variants, which may hold more grievous indications. Case Presentation: A 47-year-old female presented with an enlarging, itchy growth of several months on her back. On physical exam, an indurated pink, nontender papule of 8 mm on the left lateral side wall was noted. Histopathology demonstrated a well-circumscribed, pandermal tumor composed of anastomosing solid and cribriform nests, tubules, and cords of mildly atypical, eosinophilic epithelial cells forming a glandular lumina. An immunohistochemical study revealed the tumoral epithelium to express CK7, CK5/6, BER-EP4, CD117 (C-kit), and S100. Positive EMA and CEA staining highlighted intratumoral glandular ductal differentiation and apocrine secretion. Immunohistochemical stains for CK20, GATA-3, and p63 were negative. Conclusions: We present this case to distinguish the histological attributes of PCCAC and help differentiate it from more concerning visceral metastatic malignancies. We follow with a narrative review of the histopathologic differential for PCCAC and feature reconciliation of corresponding staining patterns reported in the literature.

The Atopic Dermatitis Control Tool (ADCT) is a validated six-item tool used in clinical trials to assess eczema control in adolescents and adults. Two versions of the ADCT were recently developed using a US Food and Drug Administration-recommended methodology. One is intended for use with caregivers of children aged 6 months to 11 years (the Caregiver ADCT; score range 0–24; higher scores indicate worse control; recall period the past 7 days). The other, the Child Eczema Control Tool (ECT), is intended for use with children aged 8 to 11 years. We conducted the first psychometric validation of the Caregiver ADCT (first 100 caregivers recruited), which demonstrated no floor or ceiling effects in response distributions, except for a floor effect for ‘sleep-trouble nights’ (47% selected the least severe option; n = 47/100). There were strong inter-item correlations (r ≥ 0.57; P < 0.001) and construct validity (r ≥ 0.59; P < 0.001), consistent with a priori hypotheses. The Caregiver ADCT showed strong internal consistency (Cronbach’s α = 0.92, 95% confidence interval 0.90–0.94). A score ≥ 7 was identified as the optimal threshold for identifying children whose eczema was ‘not in control’.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Our study develops a GPT assistant for neurocutaneous diseases with a custom knowledge base, tests its ability to answer common patient questions, and shows that a GPT using retrieval augmentation generation can improve the readability of patient educational material without prompting a specific reading level.