The reported data provides normative data stratified by anatomical location, age, and gender that can be used by clinicians and researchers to objectively determine whether patients' skin characteristics vary significantly from healthy subjects.

Background Guidelines recommend variceal screening in patients with cirrhosis to identify varices at high-risk of bleeding requiring primary prophylaxis. Non-invasive criteria to rule out high-risk varices (HRV) will avoid unnecessary endoscopies. Recent Baveno VI criteria define patients with compensated cirrhosis in whom endoscopy can be avoided as those with a liver stiffness (LS) by transient elastography <20 kPa and a platelet count >150,000/mm3. Aims To validate Baveno criteria in two cohorts with a different prevalence of HRV and 2) to determine whether alternate parameters not including LS would be equal/more accurate in ruling out HRV. Methods Retrospective study evaluating patients with LS >10 kPa who had LS and endoscopy within one year of each other. Results The study included 161 patients from a U.S. cohort (14 [9%] with HRV) and 101 patients from an Italian cohort (17 [17%] with HRV). Of patients meeting Baveno criteria (41 in the US, 16 in Italy) none had HRV and therefore 26% (US) and 16% (Italy) endoscopies could have been avoided. Sensitivity and negative predictive value (NPV) were 100%. A stepwise strategy using platelet count >150,000 and MELD=6, increased the number of endoscopies avoided to 54% (US) while maintaining a sensitivity and NPV of 100%. Excellent sensitivity and NPV were validated in the Italian cohort and in another cohort of patients with a clinical diagnosis of cirrhosis. Conclusions This study validates Baveno VI criteria, particularly in sites with a low prevalence of HRV and describes a new accurate strategy that does not include LS.

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