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Abstract Background Solid organ transplant recipients (SOTRs) have an increased risk of developing non melanoma skin cancers (NMSCs). The use of Imiquimod, a toll‐like‐receptor agonist, is still debated in SOTRs. Objectives The aim of this study was to evaluate efficacy and safety of topical Imiquimod in two Dermatology Centres for skin cancers in SOTRs. Methods All SOTRs with age > 18 and a dermoscopic diagnosis of superficial basal cell carcinoma (BCC) and/or actinic keratose (AK), annually followed up between January 2022 and December 2022 were screened. Results 80 NMSCs (41 BCC and 39 AK) in 66 SOTRs were identified and treated. 57 (86.4%) were male. The mean age was 66.2 years (30−85). 60 patients (90.1%) had transplanted kidney, 1 (1.5%) lung, 3 (4.5%) liver, and 1 (1.5%) heart. The average time since first transplant was 17 years (3−40 years). Tacrolimus, steroids, and mycophenolate mofetil were the most frequently used immunosuppressants (71%; 67.7%; 53.2% of cases, respectively). Responses to the first course of treatment were CR in 64.3% of cases (53.6% in AK; 67.7% in BCC); PR in 28.6% of cases (42.9% in AK; 12.9% in BCC); NR in 12.5% of cases (3.6% in AK; 19.4% in BCC). Fourteen patients received a second course of imiquimod for a persistent lesion (1 AK, 4 BCC) or a new lesion (4 AK, 5 BCC). Responses to the second course of treatment were observed in 4 (80%) and 7 (78%) cases in the persistent and new lesion, respectively (p = 0.34). No systemic adverse events were noted. The main side effects were mild: erythema, scales, and crusts, itching, or pain. Conclusions Topical imiquimod represents a viable and safe option in this category of patients. The response to imiquimod in subjects who have had more than one cycle is not related to the response to previous treatments but rather to the intrinsic characteristics of the lesion.

Abstract is missing (Short communication)

Aim: Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) immunization in patients with autoimmune diseases is of particular concern to understand their response to the infection and to the vaccine. In fact, the immunological disorder and the immunosuppressive therapies could affect the serological response. SARS-CoV2 serological tests potentially provide this information, although they were rapidly commercialized with internal verifications. Here, we analysed the seroprevalence to SARS-CoV2 in a cohort of patients with liver autoimmune diseases. Methods: From May to December 2020, a cohort of patients affected by primary biliary cholangitis (PBC), autoimmune hepatitis (AIH) and PBC/AIH overlap syndrome were screened with reverse transcription-polymerase chain reaction (RT-PCR) of nasopharyngeal swabs, rapid antigenic test and chemiluminescent serological test during routine follow-up. Results: The analysis of 42 patients was carried out: 18 (42.85%) PBC, 12 (28.57%) AIH and 12 (28.57%) PBC/AIH overlap syndromes. Only 2 patients (4.76%) resulted positive to the RNA, antigen and antibody detection tests, hence affected by SARS-CoV2 infection. 14 subjects out of 40 negative cases presented a positive serology for SARS-CoV2 antibodies, hence with a false positivity in the 35% of cases without infection. Notably, among these, 6 (42.86%) patients presented only immunoglobulin (Ig)M positivity, 6 (42.86%) patients presented positivity for only IgG and 2 (14.28%) patients were positive to both IgM and IgG. Notably, the presence of autoantibodies did not correlate with the serological false positivity, highlighting that there is no cross-reactivity with autoantibodies. Moreover, the presence of polyclonal hypergammaglobulinemia did not interfere with the serological test as its prevalence is not different between negative and false positive cases. Interestingly, the patients with false positive serology showed higher levels of gamma-glutamyltransferase (GGT) and C-reactive protein (CRP). Conclusions: Patients with liver autoimmune diseases present a high rate of false positive SARS-CoV2 serology. Therefore, new strategies are needed to study the serological response in this patient category.

Objective: To assess the effect of statins compared with placebo on the risk of developing hypertransaminasemia. Patients and Methods: We performed a systematic review of electronic databases and included articles published between January 1, 1965, and April 10, 2017. Randomized clinical trials (RCTs) comparing statins vs placebo were included. Odds ratios (ORs) were pooled in random-effect meta-analyses according to established methods recommended by the Cochrane Collaboration. Results: Seventy-three eligible RCTs, comprising 123,051 patients, were identified. Statins associated with a significantly risk of hypertransaminasemia (OR 1.45; 95% confidence interval [CI], 1.24-1.69; P

In recent years, several non-invasive methods have been developed for staging liver fibrosis in patients with chronic hepatitis C. A 2D-Shear wave elastography (SWE) technique has been recently introduced on the EPIQ 7 US system (ElastQ), but its accuracy has not been validated in patients with chronic hepatitis C virus (HCV) infection. We enrolled 178 HCV patients to assess their liver fibrosis stage with ElastQ software using transient elastography as a reference standard. The best cut-off values to diagnose ≥ F2, ≥ F3, and F4 were 8.15, 10.31, and 12.65 KPa, respectively. Liver stiffness values had a positive correlation with transient elastography (r = 0.57; p < 0.001). The area under the receiver operating characteristics (AUROC) was 0.899 for ≥ F2 (moderate fibrosis), 0.900 for ≥ F3 (severe fibrosis), and 0.899 for cirrhosis. 2D-SWE has excellent accuracy in assessing liver fibrosis in patients with chronic hepatitis C and an excellent correlation with transient elastography.