P Saiag

Université de Versailles Saint-Quentin, Versailles, Île-de-France, France

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Publications (229)549.42 Total impact

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    ABSTRACT: As previously shown for imatinib, therapeutic drug monitoring (TDM) of vemurafenib should be important to measure efficacy of the treatment in melanoma patient. A micro-method based on liquid chromatography coupled to triple quadrupole spectrometry detection using only 10μL of plasma was validated. A simple protein precipitation with water/acetonitrile was used after addition of vemurafenib-(13)C6 as internal standard. The ion transitions used to monitor analytes were m/z 490.2→m/z 255.2 and m/z 383.3 for vemurafenib and m/z 496.2→m/z 261.2 and m/z 389.3 for vemurafenib-(13)C6. Calibration curves were linear in the 0.1-100μg/mL range, the limits of detection and quantification being 0.01μg/mL and 0.1μg/mL, respectively. The intra- and inter-assay precisions evaluated at 0.1, 0.3, 15, 45 and 80μg/mL were lower than 13.3% and the accuracies were in the 93.7-105.8 range. No matrix effect was observed. At steady state, the results of TDM of vemurafenib in 26 patients treated by 960mg twice daily (n=60 samples), 13 patients with 740mg twice daily (n=13) and one with 1200mg twice daily (n=3) showed a great variability of the pharmacokinetics of this compound.
    Journal of pharmaceutical and biomedical analysis 04/2014; 97C:29-32. · 2.45 Impact Factor
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    ABSTRACT: IMPORTANCE Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), occurs in elderly patients and has been considered as a lymphoma with a poor prognosis, with estimated 5-year specific survival rates of approximately 50%. The hypothesis of an improvement in prognosis over time has not been studied. OBJECTIVES To evaluate this hypothesis in a large series of patients and investigate factors associated with prognosis as well as improvement in the prognosis. DESIGN, SETTING, AND PARTICIPANTS A retrospective multicenter study was conducted including dermatology departments belonging to the French Study Group on Cutaneous Lymphoma. Participants were 115 patients with PCDLBCL-LT diagnosed between 1988 and 2003 (period 1) or between 2004 and 2010 (period 2). MAIN OUTCOMES AND MEASURES Age, sex, period of diagnosis, number of skin lesions, tumor stage, tumor location (leg vs nonleg), lactate dehydrogenase level, type of therapy (with or without a combination of rituximab and polychemotherapy [PCT]), and outcome were recorded. Baseline characteristics and outcome were compared according to period of diagnosis and type of therapy. Prognosis factors were identified by univariate and multivariate survival analyses. RESULTS The mean age of the patients was 76.9 years, and 47% of the patients were older than 80 years. The 3- and 5-year specific survival rates improved between period 1 and period 2, from 55% to 74% and from 46% to 66%, respectively (P = .01). Patients had similar baseline characteristics during both periods, but rituximab-PCT regimens were administered to 88.5% of the patients in period 2 vs 16.7% in period 1 (P < .001). The 3- and 5-year specific survival rates were 80% and 74%, respectively, in patients who received a rituximab-PCT regimen compared with 48% and 38% in those who received less-intensive therapies. No significant difference was observed between both groups in age and baseline prognostic factors. In multivariate analysis, treatment without rituximab-PCT was the only adverse prognostic factor (odds ratio, 4.6 [95% CI, 2.4-9.1]; P < .001), whereas the number of skin lesions (P = .06) and location on the leg (P = .07) had only borderline significance. CONCLUSIONS AND RELEVANCE A major improvement in the survival of patients with PCDLBCL-LT has occurred over time in France, mainly as a result of the use of intensive rituximab-PCT regimens in most patients, including very elderly ones. Until further prospective clinical trials are conducted, such regimens should be considered as the standard of care in these patients.
    JAMA dermatology. 03/2014;
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    ABSTRACT: In-transit metastases in cutaneous melanoma are common and difficult to manage. Therapy is mainly palliative. Use of topical imiquimod has been assessed for surface metastases. We report on four patients with cutaneous melanoma metastases treated with topical imiquimod associated with carbon dioxide laser in the first two patients and with electrocoagulation in the two others. For two patients, we noted complete regression of the lesions after 15 and 18 months. For the two others, treatment was stopped after 9 to 10 months because of progression of subcutaneous metastasis and distant metastasis. Topical imiquimod is an alternative treatment used in superficial in-transit metastasis of melanoma. Its use as a monotherapy is sometimes ineffective. We elected to use combined pre-treatment with carbon dioxide laser or electrocoagulation in order to potentiate the action of imiquimod. This simple and inexpensive therapeutic strategy constitutes a palliative treatment that can allow prolonged local control of cutaneous metastasis.
    Annales de Dermatologie et de Vénéréologie 02/2014; 141(2):106-10. · 0.60 Impact Factor
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    ABSTRACT: Background. The MC1R gene implicated in melanogenesis and skin pigmentation is highly polymorphic. Several alleles are associated with red hair and fair skin phenotypes and contribute to melanoma risk. Objective. This work aims to assess the effect of different classes of MC1R variants, notably rare variants, on melanoma risk. Methods. MC1R coding region was sequenced in 1131 melanoma patients and 869 healthy controls. MC1R variants were classified as RHC (R) and non-RHC (r). Rare variants (frequency < 1%) were subdivided into two subgroups, predicted to be damaging (D) or not (nD). Results. Both R and r alleles were associated with melanoma (OR = 2.66 [2.20-3.23] and 1.51 [1.32-1.73]) and had similar population attributable risks (15.8% and 16.6%). We also identified 69 rare variants, of which 25 were novel. D variants were strongly associated with melanoma (OR = 2.38 [1.38-4.15]) and clustered in the same MC1R domains as R alleles (intracellular 2, transmembrane 2 and 7). Conclusion. This work confirms the role of R and r alleles in melanoma risk in the French population and proposes a novel class of rare D variants as important melanoma risk factors. These findings may improve the definition of high-risk subjects that could be targeted for melanoma prevention and screening.
    BioMed Research International 01/2014; 2014:925716. · 2.88 Impact Factor
  • Journal of Pharmaceutical and Biomedical Analysis. 01/2014; 97:29–32.
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    ABSTRACT: Background In-transit metastases in cutaneous melanoma are common and difficult to manage. Therapy is mainly palliative. Use of topical imiquimod has been assessed for surface metastases. Patients and methods We report on four patients with cutaneous melanoma metastases treated with topical imiquimod associated with carbon dioxide laser in the first two patients and with electrocoagulation in the two others. For two patients, we noted complete regression of the lesions after 15 and 18 months. For the two others, treatment was stopped after 9 to 10 months because of progression of subcutaneous metastasis and distant metastasis. Discussion Topical imiquimod is an alternative treatment used in superficial in-transit metastasis of melanoma. Its use as a monotherapy is sometimes ineffective. We elected to use combined pre-treatment with carbon dioxide laser or electrocoagulation in order to potentiate the action of imiquimod. This simple and inexpensive therapeutic strategy constitutes a palliative treatment that can allow prolonged local control of cutaneous metastasis.
    Annales de Dermatologie et de Vénéréologie 01/2014; · 0.60 Impact Factor
  • Brigitte Dreno, Jean-Elie Malkin, Philippe Saiag
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    ABSTRACT: Herpes labialis (HL) is a common and benign disease. However, frequent episodes can impair quality of life (QoL) and impact healthcare consumption. The aim of this survey was to understand patients' profiles, behavior, treatment and quality of life, using web-based questionnaires administered in the USA and in France. A total of 1002 and 1005 patients completed it, respectively. Self-diagnosis of HL is usually made at the very start of the prodromal phase. In the USA, 41% of patients seek medical advice at some point and they are often prescribed a topical antiviral drug (AVD) associated with an over-the-counter drug. Those who treat HL by themselves purchase mainly non-antiviral topical drugs. In France, the treatment is almost identical (topical AVD) whether patients seek medical advice (32%) or not. In both countries, patients with 6 or more annual episodes often go to the doctor and use systemic AVD. Continuous treatment is prescribed to 55% and 35% of patients with at least 4 annual episodes, in the USA and France respectively. Sick leaves are delivered to 33% and 14% of patients, respectively. QoL is significantly impaired in a majority of patients, all the more so when HL episodes are more frequent.
    European journal of dermatology : EJD. 09/2013;
  • Sophie Lipowicz, Sophie Chagnon, Philippe Saiag
    Melanoma research 06/2013; 23(3):241. · 2.06 Impact Factor
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    ABSTRACT: Context.-Assessment of BRAF p.V600E mutational status has become necessary for treatment of patients with metastatic melanoma. Detection of p.V600E mutation by immunohistochemistry was recently reported in several tumor types. Objective.-To evaluate the interobserver reproducibility of BRAF p.V600E detection by immunohistochemistry in melanoma. Design.-Immunohistochemistry with VE1 antibody was performed on metastatic melanomas of 67 patients. Staining interpretation was performed on digital image virtual slides of tissue microarrays. The p.V600E status was determined by 7 pathologists from 3 European laboratories, blinded for other interpretations and for molecular biology results. Results.-Melanomas had p.V600E (n = 30), p.V600K (n = 4), p.K601E (n = 1), p.600-601delinsE (n = 1), or no p.V600 mutations (n = 31). Staining of p.V600E within mutated cells was cytoplasmic and diffuse, and for each case the staining on the 3 tissue microarray cores was similar. In 53 cases (79.1%) the 7 pathologists had perfect concordance. Agreement of interobserver reproducibility was almost perfect (κ = 0.81 [0.77-0.85]). Only 2 false-positive responses (0.9%) were obtained. The specificities reported were 100% for 5 pathologists (two of whom previously trained for p.V600E interpretation), and 97% for 2 untrained pathologists. Conclusions.-Detection of BRAF p.V600E mutation by immunohistochemistry in melanomas has an excellent interobserver reproducibility. Our results suggest that immunohistochemistry could be used as a first step for detection of BRAF p.V600E mutation, to identify patients with melanoma as candidates for BRAF inhibitors.
    Archives of pathology & laboratory medicine 05/2013; · 2.78 Impact Factor
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    ABSTRACT: INTRODUCTION: Blastic plasmacytoid Dentritic Cell Neoplasm (BPDCN) is, as defined in the new 2008 World health Organized (WHO) classification of tumors of hematopoietic and lymphoid tissue, a rare disease characterized by malignant proliferation of a contingent blastic plasmacytoid dendritic cell. This rare entity is mostly revealed and diagnosed on cutaneous spreading associated d'emblée or not with a leukaemic component .The prognosis is very poor. We herein studied a large cohort of 90 patients with BPDCN and try to define additional clues to coin earlier the correct diagnosis and manage such patients accordingly. MATERIALS AND METHOD: We retrospectively reviewed BPDCN cases registered in the French Study Group on Cutaneous Lymphoma (GFELC) database from November 1995 to January 2012. Ninety patients were studied. Demographic data, clinical presentation, initial staging, and outcome were recorded. RESULTS: The studied group contained 62 male and 28 female patients (sex ratio 2.2). Age ranged from 8 to 103 years at the time of diagnosis (mean age: 67.2 years).Three major different clinical presentations were identified: Sixty six patients (73.2%) presented with nodular lesions only, 11 patients with "bruise-like» patches (12.2%).The remaining 13 ones showed disseminated lesions (patches and nodules). Mucosal lesions were seen in five patients (5.6%) The median survival in patients with BPDCN was at 12 months . CONCLUSIONS: We here distinct three different clinical presentation of BPDCN. Nodular pattern is actually a more common feature than the originally reported "bruise-like" pattern. Despite the fact that BPDCN may initially appear as a localized skin tumor an aggressive management including allogenic bone marrow transplantation should be considered d'emblée since it is so far the only one option associated with long term survival. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 05/2013; · 3.76 Impact Factor
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    ABSTRACT: Cutaneous nodular amyloidosis is rare, and association with Sjögren's syndrome has been reported. We discuss the possible link between these two diseases based on a case we saw. A 78-year-old woman with Sjögren's syndrome ongoing for 17 years presented for evaluation of a waxy infiltrated lesion on her left leg that had appeared 6 months earlier. Histopathological examination revealed a deposit of homogenous eosinophilic material throughout the dermis consistent with amyloidosis. Immunohistochemical study showed these deposits to be AL immunoglobin light chains. The association of cutaneous nodular amyloidosis and Sjögren's syndrome appears to be a distinct disease entity reflecting the polymorphic clinical spectrum of lymphoproliferative diseases related to Sjögren's syndrome.
    Annales de Dermatologie et de Vénéréologie 05/2013; 140(5):378-81. · 0.60 Impact Factor
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    ABSTRACT: Background Cutaneous nodular amyloidosis is rare, and association with Sjögren's syndrome has been reported. We discuss the possible link between these two diseases based on a case we saw. Patients and methods A 78-year-old woman with Sjögren's syndrome ongoing for 17 years presented for evaluation of a waxy infiltrated lesion on her left leg that had appeared 6 months earlier. Histopathological examination revealed a deposit of homogenous eosinophilic material throughout the dermis consistent with amyloidosis. Immunohistochemical study showed these deposits to be AL immunoglobin light chains. Discussion The association of cutaneous nodular amyloidosis and Sjögren's syndrome appears to be a distinct disease entity reflecting the polymorphic clinical spectrum of lymphoproliferative diseases related to Sjögren's syndrome.
    Annales de Dermatologie et de Vénéréologie 05/2013; 140(5):378–381. · 0.60 Impact Factor
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    ABSTRACT: The benefits and the harmful effects of solar ultraviolet radiation (UVR) exposure have been well discussed. Most studies show concern for the solar overexposure in the tropics and low latitude sites and its scarcity at higher latitudes. Both cases are of concern, the first for diseases such as skin cancer and the second for the lack of vitamin D production in the skin. In this study, we evaluate the influence of climate change scenarios on the total ozone content (TOC) and typical aerosol properties, such as the optical depth (AOD) and single scattering albedo (SSA), over Europe. From these parameters, we estimate the erythemal and the vitamin D effective UVR doses from 2006 to 2100. Our results indicate a small reduction of the UVR daily doses caused by the ozone layer recovery and partially compensated by an AOD diminution through this century. The attenuation will be larger at high latitudes, during the springtime and for more polluted scenarios during this century. However, this diminution should not be sufficient to provide a protection condition for erythema. On the other hand, at higher latitudes, it possibly contributes to a relevant increase in the exposure time necessary for the synthesis of vitamin D, mainly during autumn and spring seasons.
    Photochemical and Photobiological Sciences 04/2013; · 2.92 Impact Factor
  • P Saiag
    British Journal of Dermatology 12/2012; 167(6):1199. · 3.76 Impact Factor
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    ABSTRACT: BRAF p.V600 mutation detection recently became necessary to treat metastatic melanoma patients with vemurafenib. This study compares different methods of detection of BRAF mutations. Melanoma samples from 111 patients were analyzed for BRAF mutations, and for 89 of them, results were obtained with the four following methods: Sanger sequencing, real-time PCR, immunohistochemistry, and pyrosequencing. All samples contained at least 60% of tumor cells. Directional Sanger sequencing of PCR products failed to detect 3 of 40 p.V600E-mutated cases (7.5%) (sensitivity, 92.5%; 95% CI, 78.5% to 98.0%). BRAF p.V600E-specific real-time PCR identified 39 of 40 p.V600E-mutated cases (97.6%) (sensitivity, 97.5%; 95% CI, 87.1% to 99.6%) and all 39 wild-type (WT) cases and surprisingly was also positive for 6/6 p.V600K (specificity, 87.8%; 95% CI, 75.8% to 94.3%). However, other mutations, p.V600R (n = 1), p.K601E (n = 2), and p.600_601delinsE (n = 1), were not detected. Immunohistochemistry with VE1, specific for p.V600E, identified all p.V600E and WT cases (sensitivity, 100%; 95% CI, 91.2% to 100%) but was negative for all other BRAF mutations. Pyrosequencing successfully identified all WT and mutated cases. Immunohistochemistry is highly specific for p.V600E, could be used as a first-line method, and is currently performed for HER2 amplification detection. Pyrosequencing proved to be the most efficient method to detect BRAF mutations in melanomas and could be performed on VE1-negative or uninterpretable cases.
    The Journal of molecular diagnostics: JMD 11/2012; · 3.48 Impact Factor
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    ABSTRACT: Background  High sun exposure during childhood is an important risk factor for skin cancers at adulthood. Paediatricians are first in line to provide sun protection (SP) information. Objective  To describe paediatricians' attitudes towards SP counselling and compare French and American paediatricians' behaviours. Methods  Methodology used by the American Academy of Pediatrics in 2001. Validation of the French version of the questionnaire. Survey of all 1108 paediatrician members of the Association Française de Pédiatrie Ambulatoire (AFPA) Results  More than 90% of paediatricians agreed that skin cancers are a Public Health concern, that preventing episodic high sun exposures during childhood would reduce the risk of adult melanoma, and that it is a paediatrician's role to educate parents/patients on SP. Three quarters reported counselling all of their patients. The most important SP recommendation was to avoid sun during peak hours, followed by sunscreen use. Only 48.3% of paediatricians rated SP as very important to their patients' health, at the 8th rank among selected preventive care topics. The most frequently identified barrier to SP counselling was cost of sunscreens followed by lack of sufficient time. Conclusions  The majority of paediatricians believe that prevention of skin cancers is a worthy issue and it is their role to educate patients, but less than half of them consider SP as an important topic among selected preventive care issues. Although paediatricians seem to know SP measures well, their (counselling?) seems to respond to patients' preoccupations more than to expert recommendations. French and American behaviours show some major differences.
    Journal of the European Academy of Dermatology and Venereology 10/2012; · 2.69 Impact Factor
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    ABSTRACT: As loss of KIT frequently occurs in melanoma progression, we hypothesized that KIT is implicated in predisposition to melanoma (MM). Thus, we sequenced the KIT coding region in 112 familial MM cases and 143 matched controls and genotyped Tag SNPs in 2 cohorts of melanoma patients and matched controls. Five rare KIT substitutions, all predicted possibly or probably deleterious, were identified in 5 patients, but none in controls (RR = 2.26 [1.26-2.26]). Expressed in melanocyte lines, three substitutions inhibited KIT signaling. Comparison with exomes database (7020 alleles) confirmed a significant excess of rare deleterious KIT substitutions in patients. Additionally, a common SNP, rs2237028, was associated with MM risk and 6 KIT variants associated with nevus count. Our data strongly suggest that rare KIT substitutions predispose to melanoma and that common variants at KIT locus may also impact nevus count and melanoma risk. © 2012 John Wiley & Sons A/S.
    Pigment Cell & Melanoma Research 10/2012; · 5.84 Impact Factor
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    ABSTRACT: Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. Diagnosis is made clinically and staging is based upon the AJCC system. CMs are excised with one to two centimetre safety margins. Sentinel lymph node dissection (SLND) is routinely offered as a staging procedure in patients with tumours more than 1mm in thickness, although there is as yet no clear survival benefit for this approach. Interferon-α treatment may be offered to patients with stage II and III melanoma as an adjuvant therapy, as this treatment increases at least the disease-free survival (DFS) and less clear the overall survival (OS) time. The treatment is however associated with significant toxicity. In distant metastasis, all options of surgical therapy have to be considered thoroughly. In the absence of surgical options, systemic treatment is indicated. BRAF inhibitors like vemurafenib for BRAF mutated patients as well as the CTLA-4 antibody ipilimumab offer new therapeutic opportunities apart from conventional chemotherapy. Therapeutic decisions in stage IV patients should be primarily made by an interdisciplinary oncology team ('tumour board').
    European journal of cancer (Oxford, England: 1990) 09/2012; 48(15):2375-90. · 4.12 Impact Factor
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    ABSTRACT: OBJECTIVE To summarize evidence about the recurrence of dermatofibrosarcoma protuberans (DFSP) following Mohs micrographic surgery (MMS). DATA SOURCES MEDLINE, Cochrane Library, EMBASE, Pascal, Biosis, CisMef, BDSP, Scopus, and Web of Knowledge databases were searched for the period January 1, 1995, to August 31, 2011. Search terms were Mohs micrographic surgery, dermatofibrosarcoma protuberans, and their synonyms. No language restriction was used. STUDY SELECTION Two of us selected randomized controlled trials or nonrandomized trials comparing the recurrence of DFSP among patients undergoing MMS vs wide local excision. The search retrieved 384 references, of which 31 were reviewed in detail. DATA EXTRACTION Twenty-three nonrandomized trials (4 comparative and 19 noncomparative) were included, from which data were extracted by 2 of us independently. The methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. DATA SYNTHESIS Moderate-quality evidence (level B) was found for recurrence of DFSP after MMS (1.11%; 95% CI, 0.02%-6.03%) vs after wide local excision (6.32%, 95% CI, 3.19%-11.02%). A mean raw recurrence rate of 1.03% (95% CI, 0.37%-2.22%) was found after MMS among 19 nonrandomized noncomparative trials (low-quality evidence [level C]). The mean follow-up periods ranged from 26 to 127 months. The mean time to recurrence was 68 months. CONCLUSIONS A weak recommendation is given in favor of MMS or similar surgical techniques with meticulous histologic evaluation of all margins as the first-line therapy for DFSP, particularly in recurrence-prone regions. Attention should be given to longer than a 5-year follow-up period. High-quality trials with sufficient follow-up periods should be encouraged.
    Archives of dermatology 09/2012; 148(9):1055-63. · 4.76 Impact Factor
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    ABSTRACT: Background  High sun exposure is a major risk factor of skin cancer, and physicians are first-line players in a sun-risk prevention campaign. Objectives  To survey medical students at the end of their general medical education about their knowledge and behaviours concerning natural and artificial sun risk and its prevention. Methods  A 32-question survey was e-mailed to fifth or sixth year medical school students or first-year resident, attending residency-exam preparatory courses in Paris. Results  Among 1,374 students, 570 (41.7%) completed the questionnaires. General aspects of sun-protection measures were known to >75% but responses to specific questions, mainly the impact of environmental conditions on sun risk, were frequently erroneous. Although most students declared using sunscreen and avoiding peak hours, 39% never or exceptionally (<1/year) performed skin self-examination. Fewer than one-third wore long sleeves or cap/hat in the sun, and tanning beds were used by 13.5%, but their regulations remained unknown by 30-68%. Conclusion  The sixth year of medical school signals the end of non-specialized training. Students' results and practices were almost comparable to those of the French general population. Medical schools might not be providing adequate sun-protection education programmes, perhaps diminishing the ability of future doctors to educate patients.
    Journal of the European Academy of Dermatology and Venereology 07/2012; · 2.69 Impact Factor

Publication Stats

2k Citations
549.42 Total Impact Points

Institutions

  • 2004–2014
    • Université de Versailles Saint-Quentin
      Versailles, Île-de-France, France
  • 1998–2014
    • Hôpital Ambroise Paré – Hôpitaux universitaires Paris Ile-de-France Ouest
      Billancourt, Île-de-France, France
  • 2013
    • Centre Hospitalier Universitaire de Nantes
      Naoned, Pays de la Loire, France
  • 2008–2013
    • Clinique Ambroise Paré
      Tolosa de Llenguadoc, Midi-Pyrénées, France
    • Université d'Évry-Val-d'Essonne
      • Laboratoire Statistique et Génome
      Évry, Ile-de-France, France
  • 2012
    • Fundación de Investigación del Hospital Clínico Universitario de Valencia INCLIVA
      Valenza, Valencia, Spain
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      Lutetia Parisorum, Île-de-France, France
    • CHU Ambroise Paré
      Mons, Walloon Region, Belgium
  • 2011
    • Centre Hospitalier Victor Dupouy
      Argenteuil, Île-de-France, France
    • Université de Montpellier 1
      Montpelhièr, Languedoc-Roussillon, France
  • 1993–2011
    • Hôpital Ambroise Paré Paul Desbief
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2010
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 2006–2009
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 1989–1992
    • Hôpital Henri Mondor (Hôpitaux Universitaires Henri Mondor)
      • Service de Dermatologie
      Créteil, Ile-de-France, France