B Lebrun-Vignes

Assistance Publique – Hôpitaux de Paris, Lutetia Parisorum, Île-de-France, France

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Publications (49)123.61 Total impact

  • B Lebrun-Vignes, L Valeyrie-Allanore
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    ABSTRACT: Cutaneous adverse drug reactions (CADR) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Exanthematous eruptions, urticaria and vasculitis are the most common forms of CADR. Fixed eruption is uncommon in western countries. Serious reactions (fatal outcome, sequelae) represent 2% of CADR: bullous reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), DRESS (drug reaction with eosinophilia and systemic symptoms or drug-induced hypersensitivity syndrome) and acute generalized exanthematous pustulosis (AGEP). These forms must be quickly diagnosed to guide their management. The main risk factors are immunosuppression, autoimmunity and some HLA alleles in bullous reactions and DRESS. Most systemic drugs may induce cutaneous adverse reactions, especially antibiotics, anticonvulsivants, antineoplastic drugs, non-steroidal anti-inflammatory drugs, allopurinol and contrast media. Pathogenesis includes immediate or delayed immunologic mechanism, usually not related to dose, and pharmacologic/toxic mechanism, commonly dose-dependent or time-dependent. In case of immunologic mechanism, allergologic exploration is possible to clarify drug causality, with a variable sensitivity according to the drug and to the CADR type. It includes epicutaneous patch testing, prick test and intradermal test. However, no in vivo or in vitro test can confirm the drug causality. To determine the cause of the eruption, a logical approach based on clinical characteristics, chronologic factors and elimination of differential diagnosis is required, completed with a literature search. A reporting to pharmacovigilance network is essential in case of a serious CADR whatever the suspected drug and in any case if the involved drug is a newly marketed one or unusually related to cutaneous reactions. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
    La Revue de medecine interne / fondee ... par la Societe nationale francaise de medecine interne. 11/2014;
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    ABSTRACT: Context:Thalidomide use in cutaneous sarcoidosis is based on data from small case series or case reports. Objective:To evaluate the efficacy and safety of thalidomide in severe cutaneous sarcoidosis. Design, Setting and Participants:Randomized, double-bind, parallel, placebo-controlled, investigator-masked, multicentre trial lasting 3 months, and an open-label study from month 3 to month 6. Adults with clinical and histological diagnosis of cutaneous sarcoidosis were included in nine hospital centres in France. Intervention:Patients were randomized 1:1 to oral thalidomide (100 mg once daily) or to a matching oral placebo for three months. In the course of an open-label follow-up from month 3 to month 6, all patients received thalidomide 100 mg to 200 mg daily. Main outcome measures:The proportions of patients with a partial or complete cutaneous response at month 3, based on at least a 50% improvement of 3 target lesions scored for area and infiltration, were compared across randomisation groups. Results:The intent-to-treat population included 39 patients. None of them had a complete cutaneous response. Four out of 20 patients (20%) in the thalidomide group vs 4 out of 19 patients in the placebo group (21%) had a partial cutaneous response at month 3 (difference in proportion of -1% (95% CI -26% to +24%) for thalidomide vs placebo; p=1.0). Eight patients with side effects were recorded in the thalidomide group vs 3 in the placebo group. We observed a large number of adverse event-related discontinuations in patients under thalidomide in the first 3 months (4 patients with thalidomide, 0 with placebo), and in the 3 following months (5 patients). Conclusion:At a dose of 100 mg daily for 3 months, our results do not encourage thalidomide use in cutaneous sarcoidosis. Trial registration:NCT0030552 (ClinicalTrial.gov).
    Chest 06/2014; · 7.13 Impact Factor
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    ABSTRACT: Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering skin disorder characterized by linear deposits of immunoglobulin A (IgA) along the dermoepidermal junction visualized by direct immunofluorescence (DIF). It is usually spontaneous and drug-induced. To compare clinical and histological LABD forms. This retrospective monocenter cohort study concerned 28 patients diagnosed with LABD from 1 January 1995 to 31 December 2010. Imputability determined according to the French imputability method (modified Bégaud score) and Naranjo scores, enable constitution of drug-induced or spontaneous LABD groups, whose clinical and histological features were compared with blinded analysis of images and histological patterns. Sixteen patients had spontaneous LABD and 12 had drug-induced LABD. Nikolsky's sign and large erosions were significantly more frequent in drug-induced than spontaneous LABD (P=0·003 and P=0·03 respectively), with no between-group differences for erythematous plaques, target or target-like lesions, string of pearls, location, mucosal involvement or histological features. Drug-induced LABD was more severe than the spontaneous form, with lesions mimicking toxic epidermal necrolysis. Because LABD may be polymorphic and sometimes life-threatening, DIF assay is recommended for all patients with Nikolsky's sign and large erosions. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 07/2013; · 3.76 Impact Factor
  • B. Lebrun-Vignes, O. Chosidow
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    ABSTRACT: Los dermocorticoides han transformado la terapéutica dermatológica desde que, en la década de 1950, se empezó a utilizar la hidrocortisona por vía tópica. Desde entonces, se han sintetizado compuestos derivados más potentes y las indicaciones de los dermocorticoides se han multiplicado. En la actualidad, existen unas veinte moléculas diferentes que están clasificadas según su actividad antiinflamatoria. Numerosas afecciones cutáneas, sobre todo inflamatorias o tumorales, son sensibles a los dermocorticoides. Con el fin de minimizar el riesgo de que aparezcan efectos adversos, locales o sistémicos, se deben respetar las normas establecidas, que tienen en cuenta la dermatosis tratada y su localización, así como las características del paciente. La elección del dermocorticoide (nivel de actividad, excipiente), su forma de aplicación (técnica, ritmo de aplicación) y la información al paciente y/o su entorno permiten obtener una óptima relación beneficio/riesgo.
    EMC - Tratado de Medicina. 06/2012; 16(2):1–6.
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    ABSTRACT: Background Percutalgine® (dexamethasone acetate, salicylamide and hydroxyethyl salicylate) is a topical drug marketed for treatment of benign joint conditions such as mild tendinitis, small joint arthritis and sprains. The aim of the study was to describe the cutaneous side effects of Percutalgine® in terms of clinical signs, seriousness and causal relationship of the different components. Methods We extracted from the French Pharmacovigilance database all cases of adverse skin reactions occurring after application of Percutalgine® and reported for the period between 1st January 2000 and 31st October 2010. The only files selected were those in which Percutalgine® was the sole suspected drug and/or allergological tests were positive for Percutalgine® or its components. Results Fifty-three cases were ultimately retained and analysed. The main cutaneous side effect of Percutalgine® (n = 41) was contact dermatitis with secondary extension in 15 cases. Onset was immediate in 12 cases, delayed in 32 cases and unspecified in eight cases. Twelve patients were hospitalized for inefficiency of the symptomatic treatment, extended lesions or generalized associated signs. Allergological tests were described in 14 cases and were positive for Percutalgine® (eight cases), hydroxyethyl salicylate (seven cases), salicylamide (six cases), dexamethasone (three cases), and propylene glycol (two cases). Conclusion Cutaneous side effects with Percutalgine® appear to be rare or infrequently reported. They consist chiefly of contact allergy. The component responsible for the reaction can be determined using allergological patch tests.
    Annales de Dermatologie et de Vénéréologie 05/2012; 139(5):350–354. · 0.60 Impact Factor
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    ABSTRACT: Percutalgine(®) (dexamethasone acetate, salicylamide and hydroxyethyl salicylate) is a topical drug marketed for treatment of benign joint conditions such as mild tendinitis, small joint arthritis and sprains. The aim of the study was to describe the cutaneous side effects of Percutalgine(®) in terms of clinical signs, seriousness and causal relationship of the different components. We extracted from the French Pharmacovigilance database all cases of adverse skin reactions occurring after application of Percutalgine(®) and reported for the period between 1st January 2000 and 31st October 2010. The only files selected were those in which Percutalgine(®) was the sole suspected drug and/or allergological tests were positive for Percutalgine(®) or its components. Fifty-three cases were ultimately retained and analysed. The main cutaneous side effect of Percutalgine(®) (n=41) was contact dermatitis with secondary extension in 15 cases. Onset was immediate in 12 cases, delayed in 32 cases and unspecified in eight cases. Twelve patients were hospitalized for inefficiency of the symptomatic treatment, extended lesions or generalized associated signs. Allergological tests were described in 14 cases and were positive for Percutalgine(®) (eight cases), hydroxyethyl salicylate (seven cases), salicylamide (six cases), dexamethasone (three cases), and propylene glycol (two cases). Cutaneous side effects with Percutalgine(®) appear to be rare or infrequently reported. They consist chiefly of contact allergy. The component responsible for the reaction can be determined using allergological patch tests.
    Annales de Dermatologie et de Vénéréologie 05/2012; 139(5):350-4. · 0.60 Impact Factor
  • Bénédicte Lebrun-Vignes, Laurence Le Cleach, Bruno Giraudeau, Olivier Chosidow
    Archives of dermatology 04/2012; 148(4):525-7. · 4.76 Impact Factor
  • B. Lebrun-Vignes
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    ABSTRACT: Since the year 2000, ten studies focusing on cutaneous immuno-allergic adverse drug effects have been carried out by the French regional pharmacovigilance centers. As a result, several drug products, including the sedative phenobarbital, topical chloproethazine ((Neuriplège® cream), propacetamol and topical bufexamac, have been withdrawn from the market. Concerning other drugs, such as patent blue, minocycline, pholcodine, and strontium ranelate (Protelos®), the studies have led to changes in security information or conditions of use. After three successive surveys, the decision to withdraw topical ketoprofen from the French market was finally cancelled by the European Medicines Agency. Requests for re-evaluation of the risk-benefit ratio of two drugs has been made at the European level and they are presently being undertaken; they concern strontium ranelate, the cause of hypersensitivity syndromes, and the antitussive pholcodine, suspected of inducing anaphylaxis to neuromuscular blocking agents (curares).
    Revue Française d'Allergologie 04/2012; 52(3):223–226. · 0.35 Impact Factor
  • B Lebrun-Vignes, C Kreft-Jais, A Castot, O Chosidow
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    ABSTRACT: The question of quantitative and qualitative differences between adverse drug reactions (ADRs) to tetracyclines was raised many years ago, especially for minocycline and doxycycline. To assess and compare ADRs related to tetracyclines according to sales figures in France through a national survey. ADR data were collected from the French Pharmacovigilance Database (FPD), marketing authorization holders (MAH) and the literature. Sales analyses were based on MAH data provided annually to the French Drugs Agency. Among the tetracyclines available in France, doxycycline and minocycline are the most frequently used. However, their sales decreased between 1995 and 2007, more sharply for minocycline than doxycycline. According to the FPD, based on MAH data and published reports, minocycline-associated ADRs were more serious and were reported more frequently than for the other tetracyclines. Minocycline and doxycycline ADR patterns differed: gastrointestinal disorders (especially oesophageal lesions) predominated with doxycycline, while intracranial hypertension and hepatic disorders were primarily reported with minocycline. Autoimmune disorders, drug reaction with eosinophilia and systemic symptoms (DRESS) and other hypersensitivity reactions were also more frequent with minocycline. ADRs reported with lymecycline and metacycline were essentially cutaneous and gastrointestinal disorders. In the absence of markedly better efficacy against the various indications for tetracyclines, the minocycline benefit/risk ratio was clearly lower than that of doxycycline, and possibly those of lymecycline and metacycline. In light of these findings, minocycline should no longer be considered first-line therapy for inflammatory skin disorders, especially acne.
    British Journal of Dermatology 01/2012; 166(6):1333-41. · 3.76 Impact Factor
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    ABSTRACT: Fluindione is an oral vitamin K antagonist (indanedione derivative) exclusively marketed in France and Luxembourg, known to have immuno-allergic adverse effects such as hepatitis, fever or interstitial nephritis. A few cases of drug reaction with eosinophilia and systemic symptoms (DRESS) have been reported with fluindione. The aim of the present study was to investigate fluindione-induced DRESS cases reported in France and to describe their characteristics. We searched for potential cases of DRESS with fluindione reported in the French pharmacovigilance database since 2000. Thirty-six cases of DRESS were included and concerned 17 women and 19 men. The mean age was 65 years (median: 68 years, range: 28-95 years). Kidneys and liver were the most frequent organs involved. Thirty-five cases were serious. In 5 cases, the effect was life-threatening. Most of the patients recovered. Fluindione was the only medicine suspected in 26 cases. Skin patch tests, performed in 10 cases, were positive with fluindione in 9 cases. Fluindione is not known to be a frequent cause of DRESS. However, the number of reports found is probably underestimated. The seriousness of DRESS, as all immuno-allergic adverse effects, contraindicates fluindione reintroduction. Coumarinic derivatives are the alternatives in patients who need oral anticoagulant treatment.
    European Journal of Clinical Pharmacology 07/2011; 68(1):101-5. · 2.74 Impact Factor
  • Bénédicte Lebrun-Vignes, Céline Bris, Bénédicte Lelièvre, Bertrand Diquet
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    ABSTRACT: Nails can be the target of drug-induced adverse effects, either associated with cutaneous lesions or independently. Injury of the nail matrix leads to a slowing down or a temporary arrest of the growth of the nail plate responsible for Beau's lines, Mees's lines or onychomadesis. Nail bed trauma induces an onycholysis, sometimes avoured by sunlight exposure (photo-onycholysis). Many drugs are implicated in these effects including chemotherapeutics agents such as taxanes. Paronychia is related to inflammation of the lateral nailfolds sometimes leading to pseudopyogenic granuloma, and can be induced by retinoids, indinavir and epidermal growth factor receptor inhibitor therapy. These nail disorders can result in significant pain, interfere with the quality of life and infectious complications may occur. Finally, many drugs can induce pigmentation of the nail plate (chemotherapeutics agents, tetracyclines, antimalarials, zidovudine).
    Revue Francophone des Laboratoires 05/2011; 2011(432):77-81.
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    ABSTRACT: The management of drug-induced hypersensitivity syndrome or drug reaction with eosinophilia and systemic symptoms (DRESS) is not codified. Demonstration of the reactivation of Herpesviruses illustrates the specific pathophysiology of this syndrome. Proposals for the management of DRESS were elaborated by the cutaneous adverse drug reaction working group of the French Society of Dermatology to help with its management. From a review of literature and the experience of the members of this group, consensual proposals were written about diagnostic criteria, tests, treatment options, and follow-up. These proposals will need to be validated in prospective studies. A decisional tree of treatment options is proposed, based on the severity of visceral manifestations. The importance of a rapid withdrawal of the culprit drug and of a long-term follow-up is underlined. Treatment will be adapted to the clinicobiological status (topical corticosteroid, systemic corticosteroid, intravenous gammaglobulins, antivirals).
    Annales de Dermatologie et de Vénéréologie 11/2010; 137(11):703-8. · 0.60 Impact Factor
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    ABSTRACT: To investigate the prevalence and risk factors of heart valve disease in patients having PD treated with pergolide. Prospective observational study. Patients were recruited at the Hôpital de la Pitié-Salpêtrière, Paris, France. Patients Ninety-six patients having PD treated with pergolide for longer than 3 months vs 50 control subjects. Intervention Standardized echocardiography performed by an investigator blinded to treatment status. Main Outcome Measure Moderate to severe regurgitation in at least 1 heart valve. One hundred thirty-three echocardiograms (86 in the pergolide-treated group and 47 in the control group) were analyzed in the study. Moderate to severe regurgitation was found in 15 patients treated with pergolide (17.4%) and in 2 control subjects (4.3%) (odds ratio [OR], 4.75; 95% confidence interval [CI], 1.02-22.1; P = .03). Moderate to severe regurgitation was associated with the cumulative dose of pergolide (OR, 1.37; 95% CI, 1.04-1.81 per 10-mg/kg increase; P =.03). Including the present study, the meta-analysis comprised 7 trials (394 patients treated with pergolide and 280 controls). The overall OR for moderate to severe regurgitation was 3.1 (95% CI, 1.7-5.6; P < .001) in the pergolide-treated group. Risk differences were correlated with the mean cumulative dose of pergolide (r = 0.90, P < .001). Using an end point of moderate to severe heart valve regurgitation, we performed a meta-analysis of patients having Parkinson disease (PD) treated with pergolide mesylate vs control subjects by searching PubMed (January 1, 1966, to April 1, 2007) and the Cochrane databases to identify English-language prospective observational studies that reported echocardiographic data. Heart valve disease is independently associated with the use of pergolide treatment in patients having PD and correlates with its cumulative dose. Trial Registration clinicaltrials.gov Identifier: NCT00202657.
    JAMA Neurology 01/2008; 64(12):1721-6. · 7.58 Impact Factor
  • O Chosidow, B Lebrun-Vignes
    Annales de Dermatologie et de Vénéréologie 01/2008; 134(12):942-8. · 0.60 Impact Factor
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    ABSTRACT: Efficacy of oral antiviral therapies, ie, acyclovir, valacyclovir (VACV), and famciclovir, for suppression of recurrent genital herpes was studied at different doses and regimens. We sought to compare the clinical efficacies of the different oral antiviral drugs prescribed prophylactically to suppress recurrent genital herpes. MEDLINE and EMBASE databases were searched for articles on genital herpes and selected antiviral drugs. The selected trials were: parallel randomized clinical trials testing prophylactic oral antiviral treatment of genital herpes versus placebo in immunocompetent and nonpregnant patients. Fourteen randomized clinical trials were selected, including a total of 6158 patients. The global relative risk of developing at least one recurrence during the study was reduced by 47% (95% confidence interval 45%-49%) in antiviral drug groups compared with the placebo. The best evaluated regimens, with comparable efficacies, were given twice daily, ie, acyclovir (400 mg twice daily), VACV (250 mg twice daily), and famciclovir (250 mg twice daily), or once daily (VACV 500 mg). The only end point available for all the studies was the number of patients presenting at least one recurrence of genital herpes during the observation period. The results of this first meta-analysis confirmed the high clinical efficacy of oral acyclovir, VACV, or famciclovir for prophylaxis against recurrent genital herpes.
    Journal of the American Academy of Dermatology 09/2007; 57(2):238-46. · 4.91 Impact Factor
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    ABSTRACT: PURPOSE: Chronic non infectious uveitis represents two-thirds of the causes of chronic uveitis referred in tertiary referral ophthalmology centre. One case out of 5 may evolve towards blindness. Therapy should be discussed on the basis of the uveitis severity and the diagnosis; it uses topics or systemic drugs, mainly corticosteroids and immunosuppressors. CURRENT KNOWLEDGE AND KEY POINTS: Besides corticosteroids and ciclosporin, use of immunosuppressors and biotherapy in chronic non infectious uveitis is not an indication of the Autorisation de Mise sur le Marché. However, immunosuppressors and biotherapy were the subjects of several studies, although controlled studies are scarce. Controlled studies concerned cyclosporine, azathioprine and intravenous cyclophosphamide in Behçet's disease, ciclosporine and tacrolimus in uveitis of various causes. Therapy of chronic non infectious uveitis was recently enriched by new drugs: mycophenolate mofetil, initially used in transplantation, has its indications extended to systemic diseases; TNF inhibitors initially used in therapy of systemic diseases; interferon efficacy revealed in Behçet's disease is now used in uveitis due to other causes. FUTURE PROSPECTS AND PROJECTS: Controlled studies are suitable in order to determinate the respective part of immunosuppressors and biotherapies in the treatment of chronic non infectious uveitis.
    La Revue de Médecine Interne 05/2007; 28(4):232-41. · 0.90 Impact Factor
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    ABSTRACT: PurposeChronic non infectious uveitis represents two-thirds of the causes of chronic uveitis referred in tertiary refererral ophthalmology centre. One case out of 5 may evolve towards blindness. Therapy should be discussed on the basis of the uveitis severity and the diagnosis; it uses topics or systemic drugs, mainly corticosteroids and immunosuppressors.
    La Revue de Médecine Interne 04/2007; 28(4):232-241. · 0.90 Impact Factor
  • B. Lebrun-Vignes, O. Chosidow
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    ABSTRACT: Desde que se empezó a utilizar la hidrocortisona de forma tópica en los años cincuenta, los corticoides tópicos han supuesto una revolución en el tratamiento dermatológico. Con el tiempo, se han sintetizado derivados más potentes, y sus indicaciones se han multiplicado. El tratamiento de las dermatosis inflamatorias infantiles, y, en primer lugar, el de la dermatitis atópica, ha experimentado una transformación radical gracias a estos fármacos. El uso de los corticoides tópicos en el niño ha de respetar reglas que permitan evitar en la inmensa mayoría de los casos sus efectos indeseables. Dependiendo de la dermatosis tratada y de su localización, la elección del fármaco (potencia, excipiente) y su modo de aplicación (técnicas, ritmo de aplicación) deben permitir una adecuación óptima entre un beneficio máximo y unos efectos indeseables mínimos.
    EMC - Pediatría. 01/2007; 42(2):1–9.
  • O. Chosidow, B. Lebrun-Vignes
    Annales De Dermatologie Et De Venereologie - ANN DERMATOL VENEREOL. 01/2007; 134(12):942-948.
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    ABSTRACT: Inhibitors of epidermal growth factor receptors (EGFR) constitute a new alternative treatment for patients presenting certain advanced stage solid cancers (bowel, breast, ovary). Adverse cutaneous effects of these drugs are now starting to be described. Our study involved 2 men and 2 women with no previous history of acne included in a treatment protocol comprising EGFR inhibitors. Mean age was 52 years. The primary cancers were breast, ovary, bowel and unidentified. The EGFR inhibitors used were gefitinib (ZD1839) (2 cases), carnetinib (Cl1033) and cetuximab (IMC-C225). Skin lesions appeared after 7 days and included erythematous papules and follicular pustules of the face, back and upper chest. No comedons were seen, and there were no nodules or cysts. The severity of the rash resulted in discontinuation of treatment in 2 patients with complete disappearance of skin lesions in both cases. In one patient, reduction of the dosage of gefitinib (IMC-C225) led to gradual resolution of the rash. Histological examination of papules and pustules concluded on an acute suppurative folliculitis. Smears and cultures ofa nasal lesion and pustules revealed coagulase-positive Staphylococcus aureus in 2 patients. Combined doxycycline 100 mg daily and benzoyl peroxide was prescribed for 3 months and a favourable outcome was achieved after a mean 2 weeks. EGFR inhibitors act by inhibiting mechanisms oftumour proliferation in certain cancers at advanced stages or refractory to other treatments. Our findings in these four patients are similar to the published cases in terms of rapid onset of monomorphous, papulopustular, follicular eruption without comedons. Rapid response to cyclines and benzoyl peroxide is also reported in literature. This treatment must be instituted rapidly and patients must be informed about the cutaneous side-effects of EGFR inhibitors before the start of therapy. The pathophysiology of these eruptions is still unknown. Skin signs are probably due to interaction with EGFR functions, including overexpression of EGFR in keratinocytes and hair follicles.
    Annales de Dermatologie et de Vénéréologie 04/2006; 133(3):239-42. · 0.60 Impact Factor

Publication Stats

360 Citations
123.61 Total Impact Points

Institutions

  • 2001–2013
    • Assistance Publique – Hôpitaux de Paris
      • Département de Médecine Interne
      Lutetia Parisorum, Île-de-France, France
  • 2002–2012
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      • Service de Médecine Interne 1
      Lutetia Parisorum, Île-de-France, France
  • 2007–2008
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 1999
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      Lutetia Parisorum, Île-de-France, France