H Adamski

Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France

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Publications (95)175.28 Total impact

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    ABSTRACT: Background Mutations of BRAF, NRAS and c-KIT oncogenes are preferentially described in certain histological subtypes of melanoma and linked to specific histopathological features. BRAF-, MEK- and KIT-inhibitors led to improvement in overall survival of patients harbouring mutated metastatic melanoma.Objectives To assess the prevalence and types of BRAF, NRAS, c-KIT and MITF mutations in cutaneous and mucous melanoma and to correlate mutation status with clinicopathological features and outcome.Methods Clinicopathological features and mutation status of 108 samples and of 98 consecutive patients were, respectively, assessed in one retrospective and one prospective study. Clinicopathological features were correlated with mutation status and the predictive value of these mutations was studied.ResultsThis work identified significant correlations between BRAF mutations and melanoma occurring on non-chronic sun-damaged skin and superficial spreading melanoma (P < 0.05) on one hand, and between NRAS mutations and nodular melanoma (P < 0.05) on the other hand. Younger age (P < 0.05), microscopic (P < 0.05) and macroscopic (P < 0.05) lymphatic involvement at diagnosis of primary melanoma were significantly linked to BRAF mutations. A mutated status was a positive predictive factor of a response to BRAF inhibitors (OR = 3.44). Mutated melanoma showed a significantly (P = 0.038) higher objective response rate to cytotoxic chemotherapy (26.3%) than wild-type tumours (6.7%).Conclusion Clinical and pathological characteristics of the primary melanoma differed between wild-type and BRAF- or NRAS-mutated tumours. Patients with BRAF-mutated tumours were younger at diagnosis of primary melanoma. Patients carrying mutations showed better responses better to specific kinase inhibitors and interestingly also to systemic cytotoxic chemotherapy.
    Journal of the European Academy of Dermatology and Venereology 01/2015; DOI:10.1111/jdv.12910 · 3.11 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 11/2014; DOI:10.1016/j.annder.2014.09.058 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 11/2014; DOI:10.1016/j.annder.2014.09.059 · 0.67 Impact Factor
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    ABSTRACT: Background: Retrospective data have suggested the effectiveness of intravenous immunoglobulins (IVIG) for solar urticaria (SU). Objective: We sought to prospectively assess the efficacy of IVIG for SU. Methods: We conducted a multicentric phase II study to test the efficacy of a single course of IVIG (2 g/kg) in patients with severe and refractory SU. The primary outcome was remission of SU on phototesting at 12 weeks after IVIG treatment. Secondary objectives included clinical remission, improved quality of life, and 50% improvement in disease intensity as measured on a visual analog scale. Results: Of the 9 patients who received IVIG injection, 2 showed remission of SU on phototesting, corresponding to a response rate of 22.2% (95% confidence interval 2.8%-60.0%). In all, 6 patients (67%) showed at least 1 response criterion after 4 weeks and 5 (56%) after 12 weeks. Response was maintained after 24 weeks for 2 patients and after 48 weeks for 1 patient. About half of the patients (56%) had moderate to severe headache. Limitations: Lack of control arm and small number of patients are limitations. Conclusion: A single course of IVIG appears insufficient to obtain prolonged significant control of SU; future evaluation of different schedules of IVIG administration is warranted.
    Journal of the American Academy of Dermatology 08/2014; 71(5). DOI:10.1016/j.jaad.2014.07.023 · 5.00 Impact Factor
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    ABSTRACT: Contradictory findings have recently been published on the association between atopic dermatitis (AD) severity and vitamin D deficiency. The aim of this study was to examine the correlation between 25-hydroxyvitamin D (25(OH)D) concentration and AD severity. A cross-sectional study was conducted from June 2011 to March 2013 in dermatology departments in adults and children with a diagnosis of AD. The severity of AD was assessed using the SCORAD and PO-SCORAD indexes and serum 25(OH)D concentrations were determined for all patients. Sixty patients were included: 30 with severe AD and 30 with mild-to-moderate AD. The 25(OH)D concentration was lower in patients with severe AD than in patients with mild-to-moderate AD (15.9±8.3ng/mL vs. 21.5±8.2ng/mL; P=0.01). There was a negative correlation between 25(OH)D concentration and respectively, SCORAD (r=-0.47; P<0.001) and PO-SCORAD (r=-0.4; P=0.004) values. The correlation between 25(OH)D concentrations and SCORAD values remained valid after adjustment for age, phototype and season. This study demonstrated an association between vitamin D deficiency and AD severity but showed no causal link between these variables. Confounding variables such as sun exposure and socioeconomic status were not recorded. A large-sale, comparative interventional study could confirm a real link between these two variables.
    Annales de Dermatologie et de Vénéréologie 04/2014; 141(4):265-71. DOI:10.1016/j.annder.2014.01.013 · 0.67 Impact Factor
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    ABSTRACT: Several case reports suggested that tumour necrosis factor-α (TNF) inhibitors might increase the incidence and/or alter the natural course of melanoma towards a more aggressive behaviour. Our objective was to point if history of melanoma in patients exposed to TNF inhibitors could present with a particular pattern at diagnosis or during follow-up. We performed a retrospective multicentre study settled in the West part of France to collect and analyse all cases of patients with melanoma who received anti-TNF therapy. Fifteen cases were included. First, 10 patients (mean age: 55.6 years; sex ratio: 1) had a melanoma diagnosed after TNF inhibitors initiation. The mean duration between initiation of treatment and melanoma was 48.7 months. Two patients died of metastatic disease. Second, four patients had a past history of melanoma before anti-TNF therapy (mean duration of treatment: 10.8 months). None experienced a progression of melanoma disease. Last, one woman had a past history of melanoma before and then developed a second melanoma when exposed to biotherapy. Our case series does not reveal a distinct profile of melanoma in the patients exposed to TNF inhibitors. Additional prospective trials including larger number of patient are needed to demonstrate the possible link between biological therapy with TNF inhibitors and development of melanoma.
    Journal of the European Academy of Dermatology and Venereology 12/2013; 28(11). DOI:10.1111/jdv.12347 · 3.11 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S496. DOI:10.1016/j.annder.2013.09.306 · 0.67 Impact Factor
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    ABSTRACT: Background Contradictory findings have recently been published on the association between atopic dermatitis (AD) severity and vitamin D deficiency. The aim of this study was to examine the correlation between 25-hydroxyvitamin D (25(OH)D) concentration and AD severity. Patients and methods A cross-sectional study was conducted from June 2011 to March 2013 in dermatology departments in adults and children with a diagnosis of AD. The severity of AD was assessed using the SCORAD and PO-SCORAD indexes and serum 25(OH)D concentrations were determined for all patients. Results Sixty patients were included: 30 with severe AD and 30 with mild-to-moderate AD. The 25(OH)D concentration was lower in patients with severe AD than in patients with mild-to-moderate AD (15.9 ± 8.3 ng/mL vs. 21.5 ± 8.2 ng/mL; P = 0.01). There was a negative correlation between 25(OH)D concentration and respectively, SCORAD (r = −0.47; P < 0.001) and PO-SCORAD (r = −0.4; P = 0.004) values. The correlation between 25(OH)D concentrations and SCORAD values remained valid after adjustment for age, phototype and season. Conclusion This study demonstrated an association between vitamin D deficiency and AD severity but showed no causal link between these variables. Confounding variables such as sun exposure and socioeconomic status were not recorded. A large-sale, comparative interventional study could confirm a real link between these two variables.
    Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S375–S376. DOI:10.1016/j.annder.2013.09.036 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S420. DOI:10.1016/j.annder.2013.09.126 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S361–S362. DOI:10.1016/j.annder.2013.09.008 · 0.67 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 12/2013; 140(12):S527. DOI:10.1016/j.annder.2013.09.375 · 0.67 Impact Factor
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    ABSTRACT: The treatment of advanced-stage primary cutaneous T-cell lymphomas remains challenging. Especially, large-cell transformation of mycosis fungoides is associated with a median overall survival of 2 years for all stages taken together. Little is known regarding allogeneic hematopoietic stem cell transplantation in this context. We performed a multicentre retrospective analysis of 37 cases of advanced-stage primary cutaneous T-cell lymphomas treated with allogeneic stem cell transplantation, including 20 (54%) transformed mycosis fungoides. Twenty-four patients (65%) had stage IV disease (for mycosis fungoides and Sezary syndrome) or disseminated nodal or visceral involvement (for non epidermotropic primary cutaneous T-cell lymphomas). After a median follow-up of 29 months, 19 patients experienced a relapse, leading to a 2-year cumulative incidence of relapse of 56% (95% CI, 0.38-0.74). Estimated 2-year overall survival was 57% (95% CI, 0.41-0.77) and progression-free survival 31% (95% CI, 0.19-0.53). Six of 19 patients with a post-transplant relapse achieved a subsequent complete remission after salvage therapy, with a median duration of 41 months. A weak residual tumor burden before transplantation was associated with increased progression-free survival (HR=0.3, 95%CI, 0.1-0.8, p=0.01). The use of antithymocyte globulin significantly reduced progression-free survival (HR=2.9, 95%CI, 1.3-6.2, p=0.01) but also transplant-related mortality (HR=10-7, 95%CI, 4.10-8-2.10-7, p<0.001) in univariate analysis. In multivariate analysis, the use of antithymocyte globulin was the only factor significantly associated with decreased progression-free survival (p=0.04). Allogeneic stem cell transplantation should be considered in advanced-stage primary cutaneous T-cell lymphomas, including transformed mycosis fungoides.
    Haematologica 11/2013; DOI:10.3324/haematol.2013.098145 · 5.87 Impact Factor
  • Annales de Dermatologie et de Vénéréologie 11/2012; 139(11):740-2. DOI:10.1016/j.annder.2012.06.044 · 0.67 Impact Factor
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    ABSTRACT: Low-molecular-weight heparins are widely used for the prophylaxis and treatment of venous thromboembolism. However, they can induce adverse skin reactions. The most common reactions are delayed-type hypersensitivity reactions at injection sites. Rare systemic reactions have been reported. We report, to our knowledge, the first case of a drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) due to enoxaparin which belongs to the low-molecular-weight heparins class.
    Case Reports in Dermatology 09/2012; 4(3):233-7. DOI:10.1159/000345096
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    ABSTRACT: Photo-recall phenomenon is a phototoxic eruption occurring on areas of previous ultraviolet-induced solar erythema following a systemic administration of a drug. It has been mostly described with methotrexate but remains rare with other antineoplastic drugs. We describe a case of docetaxel-induced photo-recall skin rash in a woman treated for a non-small-cell lung cancer. Although the patient has refused to receive a second infusion, chemotherapy can be carried on with photoprotection and the use of topical and/or systemic corticosteroids. In contrast, radiation recall is a well-known reaction by oncologists, most of them may not be aware of a similar phenomenon called photo-recall phenomenon. Recognizing this entity may avoid misdiagnosing a drug allergy and should avoid inappropriate decisions of drug discontinuation.
    Photodermatology Photoimmunology and Photomedicine 08/2012; 28(4):222-3. DOI:10.1111/j.1600-0781.2012.00669.x · 1.30 Impact Factor
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    ABSTRACT: EB naevus (EBN) are little-known, atypical, eruptive, pigmented melanocytic lesions that may occur in former sites of bullae occurring in epidermolysis bullosa hereditaria (EBH). We sought to describe the characteristics of such lesions and assess their course. This was a retrospective, two-centre study in which data was collated from the medical files of patients with EBN. We analyzed the patients' demographical data as well as the clinical, dermatoscopic, pathological features of EBN and their progression. Eight patients were studied: they were principally Caucasian (5/8), with a sex ratio of 1. All variants of EBH were represented and most were recessive (63%). We analysed 22 EBN, all atypical and emerging before the age of 10 years (73%), ubiquitously distributed and measuring greater than 5 cm(2) (25%). Of the 13 EBN subjected to dermatoscopy, 12 exhibited a benign reticular pattern. Four were biopsied, and analysis revealed three common naevi and one lentigo. After a median follow-up of 8 years, the EBN seen were either stable (68%), had regressed (23%) or had disappeared (one case). No cases of melanoma were diagnosed. EBN are acquired and atypical pigmented naevi. Sixty-four cases of EBN have been reported in the literature up to date. The dermatoscopic features may be evocative of melanoma (17/23 EBN), but to our knowledge no cases of melanoma at a naevus site have been reported. Recessive transmission of EBH appears to be a risk factor (63% of cases), a finding supported by certain pathophysiological hypotheses. EBN present atypical clinical and dermatoscopic features. However, while prophylactic total excision did not appear warranted in the absence of any reported cases of melanoma, regular clinical follow-up is recommended.
    Annales de Dermatologie et de Vénéréologie 06/2012; 139(6-7):435-43. · 0.67 Impact Factor
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    ABSTRACT: Background EB naevus (EBN) are little-known, atypical, eruptive, pigmented melanocytic lesions that may occur in former sites of bullae occurring in epidermolysis bullosa hereditaria (EBH). We sought to describe the characteristics of such lesions and assess their course. Patients and methods This was a retrospective, two-centre study in which data was collated from the medical files of patients with EBN. We analyzed the patients’ demographical data as well as the clinical, dermatoscopic, pathological features of EBN and their progression. Results Eight patients were studied: they were principally Caucasian (5/8), with a sex ratio of 1. All variants of EBH were represented and most were recessive (63%). We analysed 22 EBN, all atypical and emerging before the age of 10 years (73%), ubiquitously distributed and measuring greater than 5 cm2 (25%). Of the 13 EBN subjected to dermatoscopy, 12 exhibited a benign reticular pattern. Four were biopsied, and analysis revealed three common naevi and one lentigo. After a median follow-up of 8 years, the EBN seen were either stable (68%), had regressed (23%) or had disappeared (one case). No cases of melanoma were diagnosed. Discussion EBN are acquired and atypical pigmented naevi. Sixty-four cases of EBN have been reported in the literature up to date. The dermatoscopic features may be evocative of melanoma (17/23 EBN), but to our knowledge no cases of melanoma at a naevus site have been reported. Recessive transmission of EBH appears to be a risk factor (63% of cases), a finding supported by certain pathophysiological hypotheses. Conclusion EBN present atypical clinical and dermatoscopic features. However, while prophylactic total excision did not appear warranted in the absence of any reported cases of melanoma, regular clinical follow-up is recommended.
    Annales de Dermatologie et de Vénéréologie 06/2012; 139(s 6–7):435–443. DOI:10.1016/j.annder.2012.03.020 · 0.67 Impact Factor
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    ABSTRACT: Abstract Background: Metastatic melanoma is one of the most aggressive tumours, with a median survival that does not exceed 12 months. None of the cytotoxic first-line therapies have shown survival benefit in randomised clinical trials. Objective: To describe clinical benefit of second-line cytotoxic chemotherapy in the second line of treatment for metastatic melanoma. Methods: In a retrospective study, we analyse the outcome of patients with metastatic melanoma who had received two lines or more of cytotoxic treatments in four French dermato-oncology departments between 1999 and 2009. Results:We describe the outcomes for 109 patients. Most of these patients received dacarbazine for the first line of chemotherapy and fotemustine for the second line of chemotherapy (67.0 and 64.2%, respectively). A clinical benefit was observed in 24.1% of the patients and overall survival was 4.1 months after the second-line treatment. At least 23.8% of patients suffered from grade 3 or 4 toxicities. The presence of more than two sites of metastasis and an M1c staging according to the AJCC classification represented negative predictive factors of clinical benefit. Conclusion: This study shows the modest benefit of a second line of cytotoxic chemotherapy in a nonselected population. If eligible, these patients should be proposed for ongoing clinical trials or for targeted therapies.
    Journal of Dermatological Treatment 05/2012; DOI:10.3109/09546634.2012.697986 · 1.76 Impact Factor
  • H. Adamski, M. Viguier
    Annales de Dermatologie et de Vénéréologie 04/2012; 139(4):323. DOI:10.1016/j.annder.2012.02.002 · 0.67 Impact Factor
  • H Adamski, M Viguier
    Annales de Dermatologie et de Vénéréologie 04/2012; 139(4):324-8; quiz 323, 330. · 0.67 Impact Factor

Publication Stats

419 Citations
175.28 Total Impact Points

Institutions

  • 2012–2014
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
  • 1994–2014
    • Centre Hospitalier Universitaire de Rennes
      • Service de dermatologie
      Roazhon, Brittany, France
  • 1998–2011
    • Université de Rennes 2
      Roazhon, Brittany, France
  • 2005
    • Hôpital Universitaire Robert Debré
      Lutetia Parisorum, Île-de-France, France