Renin is increased (as well as sodium retention in kidneys) secondary to a fall in systemic vascular resistance.FibroTest is a biomarker for fibrosis that may be used instead of a biopsy.Other laboratory studies performed in newly diagnosed cirrhosis may include:

Serology for hepatitis viruses, autoantibodies (ANA, antismooth muscle, antimitochondria, anti-LKM)
Ferritin and transferrin saturation: markers of iron overload as in hemochromatosis, copper and ceruloplasmin: markers of copper overload as in Wilsons disease
Immunoglobulin levels (IgG, IgM, IgA) – these immunoglobins are nonspecific, but may help in distinguishing various causes. Cholesterol and glucose
Alpha 1-antitrypsinMarkers of inflammation and immune cell activation are typically elevated in cirrhotic patients, especially in the decompensated disease stage:

C-reactive protein (CRP)
Procalcitonin (PCT)
Presepsin
soluble CD14
soluble CD163
soluble CD206 (mannose receptor)
soluble TREM-1A recent study identified15 microbial biomarkers from the gut microbiota. These could potentially be used to discriminate patients with liver cirrhosis from healthy individuals. Pathology
The gold standard for diagnosis of cirrhosis is a liver biopsy. This is usually carried out as a fine-needle approach, through the skin (percutaneous), or internal jugular vein (transjugular). Endoscopic ultrasound-guided liver biopsy (EUS), using the percutaneous or transjugular route, has become a good alternative to use. EUS can target liver areas that are widely separated, and can deliver bi-lobar biopsies. A biopsy is not necessary if the clinical, laboratory, and radiologic data suggest cirrhosis. Furthermore, a small but significant risk of complications is associated with liver biopsy, and cirrhosis itself predisposes for complications caused by liver biopsy.Once the biopsy is obtained, a pathologist will study the sample.
Condylomas and warts can clinically resemble seborrheic keratoses, and dermatoscopy can be helpful. On the penis and genital skin, condylomas and seborrheic keratoses can be difficult to differentiate, even on biopsy.A study examining over 4,000 biopsied skin lesions identified as seborrheic keratoses showed 3.1% were malignancies. Two thirds of those were squamous cell carcinoma. To date, the gold standard in the diagnosis of seborrheic keratosis is represented by the histolopathologic analysis of a skin biopsy. Subtypes
Seborrheic keratoses may be divided into the following types:

Main differential diagnoses
Dermatosis papulosa nigra (DPN) is a condition of many small, benign skin lesions on the face, a condition generally presenting on dark-skinned individuals. : 638–9  DPN is extremely common, affecting up to 30% of Black people in the US. Treatment
No treatment of seborrheic keratoses is necessary, except for aesthetic reasons. Generally, lesions can be treated with electrodesiccation and curettage, or cryosurgery. When correctly performed, removal of seborrheic keratoses will not cause much visible scarring. Epidemiology
Seborrheic keratosis is the most common benign skin tumor. Incidence increases with age. There is less prevalence in people with darker skin. In large-cohort studies, 100% of the patients over age 50 had at least one seborrheic keratosis. Onset is usually in middle age, although they are common in younger patients too—found in 12% of 15-year-olds to 25-year-olds—making the term "senile keratosis" a misnomer. See also
The sign of Leser-Trélat

Notes
References
External links

DermAtlas 185