122 results on '"Esther E. Freeman"'
Search Results
2. Chronic spontaneous urticaria after COVID-19 primary vaccine series and boosters
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Alexis Strahan, MSN, Rowanne Ali, BS, and Esther E. Freeman, MD, PhD
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chronic idiopathic urticaria ,chronic spontaneous urticaria ,COVID-19 ,cutaneous ,dermatology ,injection ,Dermatology ,RL1-803 - Published
- 2022
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3. Barriers and facilitators to chemotherapy initiation and adherence for patients with HIV-associated Kaposi’s sarcoma in Kenya: a qualitative study
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Devon E. McMahon, Rhea Singh, Linda Chemtai, Aggrey Semeere, Helen Byakwaga, Merridy Grant, Miriam Laker-Oketta, Celestine Lagat, Sigrid Collier, Toby Maurer, Jeffrey Martin, Ingrid V. Bassett, Lisa Butler, Samson Kiprono, Naftali Busakhala, and Esther E. Freeman
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Kaposi sarcoma ,HIV/AIDS ,Chemotherapy ,Treatment ,Adherence ,Africa South of the Sahara ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Kaposi sarcoma is one of the most prevalent HIV-associated malignancies in sub-Saharan Africa and is often diagnosed at advanced stage of disease. Only 50% of KS patients who qualify for chemotherapy receive it and adherence is sub-optimal. Methods 57 patients > 18 years with newly diagnosed KS within the AMPATH clinic network in Western Kenya were purposively selected to participate in semi-structured interviews stratified by whether they had completed, partially completed, or not completed chemotherapy for advanced stage KS. We based the interview guide and coding framework on the situated Information, Motivation, Behavioral Skills (sIMB) framework, in which the core patient centered IMB constructs are situated into the socioecological context of receiving care. Results Of the 57 participants, the median age was 37 (IQR 32–41) and the majority were male (68%). Notable barriers to chemotherapy initiation and adherence included lack of financial means, difficulty with convenience of appointments such as distance to facility, appointment times, long lines, limited appointments, intrapersonal barriers such as fear or hopelessness, and lack of proper or sufficient information about chemotherapy. Factors that facilitated chemotherapy initiation and adherence included health literacy, motivation to treat symptoms, improvement on chemotherapy, prioritization of self-care, resilience while experiencing side effects, ability to carry out behavioral skills, obtaining national health insurance, and free chemotherapy. Conclusion Our findings about the barriers and facilitators to chemotherapy initiation and adherence for KS in Western Kenya support further work that promotes public health campaigns with reliable cancer and chemotherapy information, improves education about the chemotherapy process and side effects, increases oncology service ability, supports enrollment in national health insurance, and increases incorporation of chronic disease care into existing HIV treatment networks.
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- 2022
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4. A type III effectiveness-implementation hybrid evaluation of a multicomponent patient navigation strategy for advanced-stage Kaposi’s sarcoma: protocol
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Sigrid Collier, Aggrey Semeere, Helen Byakwaga, Miriam Laker-Oketta, Linda Chemtai, Anjuli D. Wagner, Ingrid V. Bassett, Kara Wools-Kaloustian, Toby Maurer, Jeffrey Martin, Samson Kiprono, and Esther E. Freeman
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Effectiveness-implementation hybrid ,Kaposi’s sarcoma ,HIV-associated malignancies ,Low- and middle-income countries ,Medicine (General) ,R5-920 - Abstract
Abstract Background For people with advanced-stage Kaposi’s sarcoma (KS), a common HIV-associated malignancy in sub-Saharan Africa, mortality is estimated to be 45% within 2 years after KS diagnosis, despite increasingly wide-spread availability of antiretroviral therapy and chemotherapy. For advanced-stage KS, chemotherapy in addition to antiretroviral therapy improves outcomes and saves lives, but currently, only ~50% of people with KS in western Kenya who have an indication for chemotherapy actually receive it. This protocol describes the evaluation of a multicomponent patient navigation strategy that addresses common barriers to service penetration of and fidelity to evidence-based chemotherapy among people with advanced-stage KS in Kenya. Methods This is a hybrid type III effectiveness-implementation study using a non-randomized, pre- post-design nested within a longitudinal cohort. We will compare the delivery of evidence-based chemotherapy for advanced-stage KS during the period before (2016–2020) to the period after (2021–2024), the rollout of a multicomponent patient navigation strategy. The multicomponent patient navigation strategy was developed in a systematic process to address key determinants of service penetration of and fidelity to chemotherapy in western Kenya and includes (1) physical navigation and care coordination, (2) video-based education, (3) travel stipend, (4) health insurance enrollment assistance, (5) health insurance stipend, and (6) peer mentorship. We will compare the pre-navigation period to the post-navigation period to assess the impact of this multicomponent patient navigation strategy on (1) implementation outcomes: service penetration (chemotherapy initiation) and fidelity (chemotherapy completion) and (2) service and client outcomes: timeliness of cancer care, mortality, quality of life, stigma, and social support. We will also describe the implementation process and the determinants of implementation success for the multicomponent patient navigation strategy. Discussion This study addresses an urgent need for effective implementation strategies to improve the initiation and completion of evidence-based chemotherapy in advanced-stage KS. By using a clearly specified, theory-based implementation strategy and validated frameworks, this study will contribute to a more comprehensive understanding of how to improve cancer treatment in advanced-stage KS.
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- 2022
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5. Vitiligo of the arm after COVID-19 vaccination
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Rhea Singh, BS, Jay L. Cohen, MD, Michael Astudillo, MD, John E. Harris, MD, PhD, and Esther E. Freeman, MD, PhD
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COVID-19 ,depigmentation ,SARS-CoV-2 ,vaccines ,vitiligo ,Dermatology ,RL1-803 - Published
- 2022
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6. Dermatology on the global stage: The role of dermatologists in international health advocacy and COVID-19 research
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Sonya Prasad, MSc, Ingrid V. Bassett, MD, MPH, and Esther E. Freeman, MD, PhD
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Global health ,infectious disease ,COVID-19 ,neglected tropical diseases ,scabies ,health policy ,Dermatology ,RL1-803 - Abstract
Background: Over the last decade, there has been a surge in interest and funding for global health dermatology. Skin conditions are now recognized as the fourth leading cause of nonfatal disease burden worldwide in disability-adjusted life years. Dermatologists are uniquely positioned within global health because skin conditions are often the presenting sign of severe illnesses, such as neglected tropical diseases and COVID-19. Methods: We review four major areas of work by dermatologists within global health: i) characterization of global burden of skin disease, ii) advocacy for dermatologic therapies on the World Health Organization's Model List of Essential Medicines, iii) advancements in global programming for skin-related tropical diseases, and iv) the role of dermatologists during the COVID-19 pandemic. For each area of work, the significance and impact on the health of women and girls is briefly highlighted. Results: Dermatologists have led the efforts to quantify and evaluate the global burden of skin disease, the burden of which is disproportionately shared by women. The dermatology community has also championed global efforts to eliminate skin-related neglected tropical diseases, such as scabies. Through national and international policy advocacy, dermatologists have pushed for more dermatologic therapies in the World Health Organization's Model List of Essential Medicines, helping to secure better care for patients with skin disease throughout the world. Since 2020, the dermatology community has worked collaboratively in the fight against COVID-19, establishing a worldwide registry for cutaneous manifestations of SARS-CoV-2 and pursuing research that has allowed colleagues in the house of medicine to better understand this landmark disease. Conclusion: Through the study and promotion of global health, dermatologists have an important role in the house of medicine.
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- 2021
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7. Real-world use of chemotherapy for Kaposi’s sarcoma in a large community-based HIV primary care system in Kenya
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Esther E. Freeman, Naftali Busakhala, Susan Regan, Fredrick Chite Asirwa, Megan Wenger, Divya Seth, Khatiya Chelidze Moon, Aggrey Semeere, Toby Maurer, Kara Wools-Kaloustian, Ingrid Bassett, and Jeffrey Martin
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Kaposi’s sarcoma ,HIV-associated malignancy ,Chemotherapy ,Cancer care ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Kaposi’s sarcoma (KS) is one of the most common HIV-associated malignancies in sub-Saharan Africa. Worldwide, the availability of antiretroviral therapy (ART) has improved KS survival. In resource-rich settings, survival has also benefited from chemotherapy, which is widely available. Little is known, however, about the epidemiology of chemotherapy use for HIV-associated KS in resource-limited regions such as sub-Saharan Africa. Methods We identified all patients newly diagnosed with HIV-related KS from 2009 to 2012 in the 26-clinic AMPATH network, a large community-based care network in Kenya. We ascertained disease severity at diagnosis, frequency of initiation of chemotherapy, and distribution of chemotherapeutic regimens used. Indications for chemotherapy included AIDS Clinical Trial Group T1 stage and/or “severe” disease defined by WHO KS treatment guidelines. Results Of 674 patients diagnosed with KS, charts were available for 588; 61% were men, median age was 35 years, and median CD4 at KS diagnosis was 185 cells/μl. At time of diagnosis, 58% had at least one chemotherapy indication, and 22% had more than one indication. For patients with a chemotherapy indication, cumulative incidence of chemotherapy initiation (with death as a competing event) was 37% by 1 month and 56% by 1 year. Median time from diagnosis to chemotherapy initiation was 25 days (IQR 1–50 days). In multivariable regression, patients with > 3 chemotherapy indications at time of diagnosis had a 2.30 (95% CI 1.46–3.60) increased risk of rapid chemotherapy initiation (within 30 days of diagnosis) compared to those with only one chemotherapy indication (p
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- 2020
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8. 25 Years of Kaposi Sarcoma Herpesvirus: Discoveries, Disparities, and Diagnostics
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Devon E. McMahon, Toby Maurer, and Esther E. Freeman
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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9. Treatment of Dermatological Conditions Associated with HIV/AIDS: The Scarcity of Guidance on a Global Scale
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Suchismita Paul, Rachel Evans, Toby Maurer, Lulu M. Muhe, and Esther E. Freeman
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Background. Skin diseases associated with Human Immunodeficiency Virus (HIV) infection are associated with significant morbidity and mortality. In resource-limited settings, nondermatologists and lay health care providers on the front line of HIV care provide much of the treatment for these conditions. Objective. To evaluate guidelines for treatment of HIV-related skin conditions and assess their accessibility, comprehensiveness, and quality of evidence employed. Methods. A review was undertaken of all national and society guidelines which included treatment information on the ten highest burden HIV-related skin conditions. The search strategy included gray and peer-reviewed literature. Results. Of 430 potential guidelines, 86 met inclusion criteria, and only 2 were written specifically to address HIV-related skin diseases as a whole. Treatment information for HIV-related skin conditions was embedded within guidelines written for other purposes, primarily HIV/AIDs treatment guidelines (49%). Development of guidelines relied either partially or completely on expert opinion (62%). Only 16% of guidelines used gradation of evidence quality and these were primarily from high-income countries (p=0.001). Limitations. Due to the nature of gray literature, not all guidelines may have been identified. Conclusion. This review highlights the need for evidence-based summary guidelines that address treatment for HIV-related skin conditions in an accessible format.
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- 2016
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10. A dermatologic assessment of 101 mpox (monkeypox) cases from 13 countries during the 2022 outbreak: Skin lesion morphology, clinical course, and scarring
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Sonya Prasad, Cristina Galvan Casas, Alexis G. Strahan, L. Claire Fuller, Klint Peebles, Andrea Carugno, Kieron S. Leslie, Joanna L. Harp, Teodora Pumnea, Devon E. McMahon, Misha Rosenbach, Janet E. Lubov, Geoffrey Chen, Lindy P. Fox, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Terrence A. Cronin, Mark D. Kaufmann, George J. Hruza, Lars E. French, Esther E. Freeman, Prasad, S, Casas, C, Strahan, A, Fuller, L, Peebles, K, Carugno, A, Leslie, K, Harp, J, Pumnea, T, Mcmahon, D, Rosenbach, M, Lubov, J, Chen, G, Fox, L, Mcmillen, A, Lim, H, Stratigos, A, Cronin, T, Kaufmann, M, Hruza, G, French, L, and Freeman, E
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medical dermatology ,mpox ,immunocompromised ,general dermatology ,international health ,infectious disease ,vaccine ,viru ,skin lesion ,global health ,monkeypox ,viral infection ,Dermatology - Abstract
Background: In the 2022 mpox (monkeypox) outbreak, 79,000 global cases have been reported. Yet, limited dermatologic data have been published regarding lesion morphology and progression. Objective: The objective of this study was to characterize skin lesion morphology, symptomatology, and outcomes of mpox infection over time. Methods: The American Academy of Dermatology/International League of Dermatological Societies Dermatology COVID-19, Mpox, and Emerging Infections Registry captured deidentified patient cases of mpox entered by health care professionals. Results: From August 4 to November 13, 2022, 101 cases from 13 countries were entered, primarily by dermatologists (92%). Thirty-nine percent had fewer than 5 lesions. In 54% of cases, skin lesions were the first sign of infection. In the first 1-5 days of infection, papules (36%), vesicles (17%), and pustules (20%) predominated. By days 6-10, pustules (36%) were most common, followed by erosions/ulcers (27%) and crusts/scabs (24%). Crusts/scabs were the predominant morphology after day 11. Ten cases of morbilliform rash were reported. Scarring occurred in 13% of the cases. Limitations: Registry-reported data cannot address incidence. There is a potential reporting bias from the predilection to report cases with greater clinical severity. Discussion: These findings highlight differences in skin findings compared to historical outbreaks, notably the presence of skin lesions prior to systemic symptoms and low overall lesion counts. Scarring emerged as a major possible sequela.
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- 2023
11. Proposing a standardized assessment of COVID-19 vaccine-associated cutaneous reactions
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Rhea Singh, Rowanne Ali, Sonya Prasad, Steven T. Chen, Kimberly Blumenthal, and Esther E. Freeman
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Dermatology - Published
- 2023
12. Cutaneous manifestations of SARS-CoV-2 infection during the Delta and Omicron waves in 348 691 UK users of the UK ZOE COVID Study app
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Alessia Visconti, Benjamin Murray, Niccolò Rossi, Jonathan Wolf, Sebastien Ourselin, Tim D. Spector, Esther E. Freeman, Veronique Bataille, and Mario Falchi
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SARS-CoV-2 ,Humans ,COVID-19 ,Dermatology ,Exanthema ,Mobile Applications ,United Kingdom ,Retrospective Studies - Abstract
Summary Background Symptoms of SARS-CoV-2 infection have differed during the different waves of the pandemic but little is known about how cutaneous manifestations have changed. Objectives To investigate the diagnostic value, frequency and duration of cutaneous manifestations of SARS-CoV-2 infection and to explore their variations between the Delta and Omicron waves of the pandemic. Methods In this retrospective study, we used self-reported data from 348 691 UK users of the ZOE COVID Study app, matched 1 : 1 for age, sex, vaccination status and self-reported eczema diagnosis between the Delta and Omicron waves, to assess the diagnostic value, frequency and duration of five cutaneous manifestations of SARS-CoV-2 infection (acral, burning, erythematopapular and urticarial rash, and unusual hair loss), and how these changed between waves. We also investigated whether vaccination had any effect on symptom frequency. Results We show a significant association between any cutaneous manifestations and a positive SARS-CoV-2 test result, with a diagnostic value higher in the Delta compared with the Omicron wave (odds ratio 2·29, 95% confidence interval 2·22–2·36, P < 0·001; and odds ratio 1·29, 95% confidence interval 1·26–1·33, P < 0·001, respectively). Cutaneous manifestations were also more common with Delta vs. Omicron (17·6% vs. 11·4%, respectively) and had a longer duration. During both waves, cutaneous symptoms clustered with other frequent symptoms and rarely (in < 2% of the users) as first or only clinical sign of SARS-CoV-2 infection. Finally, we observed that vaccinated and unvaccinated users showed similar odds of presenting with a cutaneous manifestation, apart from burning rash, where the odds were lower in vaccinated users. Conclusions Cutaneous manifestations are predictive of SARS-CoV-2 infection, and their frequency and duration have changed with different variants. Therefore, we advocate for their inclusion in the list of clinically relevant COVID-19 symptoms and suggest that their monitoring could help identify new variants. What is already known about this topic? Several studies during the wildtype COVID-19 wave reported that patients presented with common skin-related symptoms.It has been observed that COVID-19 symptoms differ among variants.No study has focused on how skin-related symptoms have changed across different variants. What does this study add? We showed, in a community-based retrospective study including over 348 000 individuals, that the presence of cutaneous symptoms is predictive of SARS-CoV-2 infection during the Delta and Omicron waves and that this diagnostic value, along with symptom frequency and duration, differs between variants.We showed that infected vaccinated and unvaccinated individuals reported similar skin-related symptoms during the Delta and Omicron waves, with only burning rashes being less common after vaccination.
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- 2022
13. Monkeypox emerges on a global scale: A historical review and dermatologic primer
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Josh, Bryer, Esther E, Freeman, and Misha, Rosenbach
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Africa ,Humans ,Monkeypox ,Public Health ,Dermatology ,Monkeypox virus ,Disease Outbreaks - Abstract
The current monkeypox outbreak reawakens the concern that poxviridae have a high potential for zoonotic spillover and causing a pandemic. Much fieldwork and research have been done by health care and public health workers in Africa during previous human outbreaks, and their knowledge should inform our global response to the current outbreak. However, unusual clinical presentations now have potential implications for recognizing the disease. In addition, infections from poxviridae, such as monkeypox, have common cutaneous signs that occur early, may be related to periods of transmissibility, and can leave scarring. Therefore, dermatologists will play a key role in recognizing and diagnosing infections and educating and preparing frontline health care workers for the early detection of new cases and clusters of monkeypox.
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- 2022
14. The BJD’s approach to global health and equity in publishing: adding author reflexivity statements
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Esther E Freeman, Valeska Padovese, Archana Singal, Rie Yotsu, Linda Oyesiku, Alaina J James, Francisco G Bravo, and Anisa Mosam
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Dermatology - Abstract
The editors of the BJD’s Global Health and Equity section describe updated submission guidelines for their section, highlighting the role of structured author reflexivity statements in improving equitable publishing practices in the dermatological literature.
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- 2023
15. Urticaria after COVID-19 vaccination and vaccine hesitancy
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Allen, Judd, Upeka, Samarakoon, Anna, Wolfson, Aleena, Banerji, Esther E, Freeman, and Kimberly G, Blumenthal
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Immunology and Allergy - Published
- 2023
16. Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin
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Rhea, Singh and Esther E, Freeman
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Dermatology - Abstract
This review aims to evaluate the spectrum of cutaneous reactions after both SARS-CoV-2 infection and COVID-19 vaccination while simultaneously understanding the evolution of the field of dermatology in the face of an ongoing pandemic.The most commonly reported cutaneous reactions after COVID-19 infection in the literature to date include morbilliform or maculopapular rashes, chilblains, and urticaria. The incidence of cutaneous reactions after COVID-19 vaccination was 9% in larger cohort studies and more commonly occurred after mRNA-based COVID-19 vaccines than adenovirus vector vaccines. The most frequently reported cutaneous reactions after COVID-19 vaccines were delayed large local reactions, local injection site reactions, urticarial eruptions, and morbilliform eruptions.With the ongoing pandemic, and continued development of new COVID-19 variants and vaccines, the landscape of cutaneous reactions continues to rapidly evolve. Dermatologists have an important role in evaluating skin manifestations of the virus, as well as discussion and promoting COVID-19 vaccination for their patients.
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- 2022
17. Three years on, COVID-19 and the skin: long-term impacts, emerging trends and clinical practice
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Esther E Freeman, Ignacio Garcia-Doval, Luigi Naldi, and Roderick J Hay
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Dermatology - Published
- 2023
18. The American Academy of Dermatology and International League of Dermatological Societies Monkeypox Registry: Expanding the COVID-19 registry to emerging infections
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Esther E. Freeman, Cristina Galvan Casas, Sonya Prasad, Claire Fuller, Klint Peebles, Misha Rosenbach, Lindy Fox, Devon E. McMahon, Alexis Strahan, Janet Lubov, Geoffrey Chen, Cuong V. Nguyen, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Mark D. Kaufmann, George J. Hruza, and Lars French
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Humans ,COVID-19 ,Monkeypox ,Registries ,Dermatology ,United States ,Societies, Medical - Abstract
The World Health Organization declared the global monkeypox outbreak a public health emergency of international concern in July 2022. In response, the American Academy of Dermatology and International League of Dermatological Societies expanded the existing COVID-19 Dermatology Registry to become the "AAD/ILDS Dermatology COVID-19, Monkeypox, and Emerging Infections Registry." The goal of the registry is to rapidly collate cases of monkeypox and other emerging infections and enable prompt dissemination of findings to front-line healthcare workers and other members of the medical community. The registry is now accepting reports of monkeypox cases and cutaneous reactions to monkeypox/smallpox vaccines. The success of this collaborative effort will depend on active case entry by the global dermatology community.
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- 2022
19. Mpox first skin lesion location: a reflection of mode of transmission?
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Lubov, J, Strahan, A, Prasad, S, Galvan Casas, C, Claire Fuller, L, Peebles, K, Carugno, A, Leslie, K, Harp, J, Pumnea, T, Mcmahon, D, Rosenbach, M, Chen, G, Fox, L, Mcmillen, A, Lim, H, Stratigos, A, A Cronin, T, Kaufmann, M, Hruza, G, French, L, E. Freeman., E, Janet E. Lubov, Alexis Strahan, Sonya Prasad, Cristina Galvan Casas, L. Claire Fuller, Klint Peebles, Andrea Carugno, Kieron S. Leslie, Joanna L. Harp, Teodora Pumnea, Devon E. McMahon, Misha Rosenbach, Geoffrey Chen, Lindy P. Fox, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Terrence A Cronin, Mark D. Kaufmann, George J. Hruza, Lars E. French, Esther E. Freeman., Lubov, J, Strahan, A, Prasad, S, Galvan Casas, C, Claire Fuller, L, Peebles, K, Carugno, A, Leslie, K, Harp, J, Pumnea, T, Mcmahon, D, Rosenbach, M, Chen, G, Fox, L, Mcmillen, A, Lim, H, Stratigos, A, A Cronin, T, Kaufmann, M, Hruza, G, French, L, E. Freeman., E, Janet E. Lubov, Alexis Strahan, Sonya Prasad, Cristina Galvan Casas, L. Claire Fuller, Klint Peebles, Andrea Carugno, Kieron S. Leslie, Joanna L. Harp, Teodora Pumnea, Devon E. McMahon, Misha Rosenbach, Geoffrey Chen, Lindy P. Fox, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Terrence A Cronin, Mark D. Kaufmann, George J. Hruza, Lars E. French, and Esther E. Freeman.
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- 2023
20. Mpox in persons living with HIV: results from an international dermatologic registry
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Strahan, A, Lubov, J, Prasad, S, Galvan Casas, C, Claire Fuller, L, Peebles, K, Carugno, A, Leslie, K, Harp, J, Pumnea, T, Mcmahon, D, Rosenbach, M, Chen, G, Fox, L, Mcmillen, A, Lim, H, Stratigos, A, A Cronin, T, Kaufmann, M, Hruza, G, French, L, Freeman, E, Alexis Strahan, Janet Lubov, Sonya Prasad, Cristina Galvan Casas, L. Claire Fuller, Klint Peebles, Andrea Carugno, Kieron S. Leslie, Joanna L. Harp, Teodora Pumnea, Devon E. McMahon, Misha Rosenbach, Geoffrey Chen, Lindy P. Fox, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Terrence A Cronin, Mark D. Kaufmann, George J. Hruza, Lars E. French, Esther E. Freeman, Strahan, A, Lubov, J, Prasad, S, Galvan Casas, C, Claire Fuller, L, Peebles, K, Carugno, A, Leslie, K, Harp, J, Pumnea, T, Mcmahon, D, Rosenbach, M, Chen, G, Fox, L, Mcmillen, A, Lim, H, Stratigos, A, A Cronin, T, Kaufmann, M, Hruza, G, French, L, Freeman, E, Alexis Strahan, Janet Lubov, Sonya Prasad, Cristina Galvan Casas, L. Claire Fuller, Klint Peebles, Andrea Carugno, Kieron S. Leslie, Joanna L. Harp, Teodora Pumnea, Devon E. McMahon, Misha Rosenbach, Geoffrey Chen, Lindy P. Fox, Allen McMillen, Henry W. Lim, Alexander J. Stratigos, Terrence A Cronin, Mark D. Kaufmann, George J. Hruza, Lars E. French, and Esther E. Freeman
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- 2023
21. The impact of the American Academy of Dermatology/International League of Dermatological Societies COVID-19 registry during the pandemic: 2500 cases across 72 countries
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Alexis G. Strahan, Janet E. Lubov, Sonya Prasad, Lindy P. Fox, Devon E. McMahon, Rhea Singh, Misha Rosenbach, Seemal R. Desai, Henry W. Lim, Bruce H. Thiers, George J. Hruza, Lars E. French, and Esther E. Freeman
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Dermatology - Published
- 2023
22. The role of dermatology in Kaposi sarcoma diagnosis across 3 regions in sub-Saharan Africa
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Mukendi K.A. Kayembe, Ingrid V. Bassett, Esther E. Freeman, Naftali Busakhala, Susan Regan, Kara Wools-Kaloustian, Surbhi Grover, Devon E. McMahon, Tlotlo Ralefala, Jeffrey N. Martin, Vivian Kwaghe, Divya Seth, Elima Jedy-Agba, Linda Oyesiku, Karen Mosoajane, Toby Maurer, Kenneth Iregbu, Victoria L. Williams, and Antoine Jaquet
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medicine.medical_specialty ,Sub saharan ,business.industry ,MEDLINE ,Cancer ,Dermatology ,medicine.disease ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Global health ,Medicine ,Sarcoma ,business - Published
- 2021
23. Hair and nail reactions represent a small proportion of all <scp>COVID</scp> ‐19 dermatologic reactions in an analysis of an international <scp>COVID</scp> ‐19 dermatological registry
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Amar D. Desai, Julianne M. Falotico, Devon E. McMahon, Esther E. Freeman, Lars E. French, and Shari R. Lipner
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Dermatology - Published
- 2022
24. COVID-19 Vaccines and the Skin
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Qisi Sun, Esther E. Freeman, Devon E. McMahon, and Ramie Fathy
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medicine.medical_specialty ,Side effect ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Dermatology ,Clinical trial ,Pandemic ,Medicine ,Mass vaccination ,Observational study ,business ,Local injection ,Adverse effect - Abstract
In 2021, we entered a new phase of the COVID-19 pandemic. As mass vaccinations are underway and more vaccines are approved, it is important to recognize cutaneous adverse events. We review the dermatologic manifestations of COVID-19 vaccines as reported in clinical trial data and summarize additional observational reports of skin reactions to COVID-19 vaccines. Early-onset local injection reactions were the most common cutaneous side effects observed in clinical trials; delayed injection reactions were the most common cutaneous side effect reported outside of clinical trials. Understanding the landscape of cutaneous manifestations to COVID-19 vaccines is key to providing appropriate vaccine guidance.
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- 2021
25. Guidelines of care for the management of actinic keratosis: Executive summary
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Daniel D. Bennett, Sue Peschin, Gary Goldenberg, Todd E. Schlesinger, Daniel B. Eisen, Maryam M. Asgari, James E. Sligh, Sameer Malik, David J. Leffell, Robert P. Dellavalle, Suzanne M. Connolly, Peggy A. Wu, Esther E. Freeman, and Lindsy Frazer-Green
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medicine.medical_specialty ,Imiquimod ,Executive summary ,Future studies ,business.industry ,medicine.medical_treatment ,Actinic keratosis ,Ultraviolet protection ,Treatment options ,Dermatology ,Actinic keratoses ,medicine.disease ,Cryosurgery ,Keratosis, Actinic ,Photochemotherapy ,Practice Guidelines as Topic ,medicine ,Humans ,Fluorouracil ,Topical imiquimod ,Intensive care medicine ,business - Abstract
Background Actinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet-exposed skin and can progress to keratinocyte carcinoma. Treatment options for AK include topical medications, photodynamic therapy, cryosurgery, and laser ablation. Objective This executive summary provides a synopsis of the 18 evidence-based recommendations for the treatment of AK detailed in the Guidelines of Care for the Management of Actinic Keratosis. Methods A multidisciplinary workgroup conducted a systematic review to address 5 clinical questions on the management of AKs and applied the Grading of Recommendations Assessment, Development and Evaluation approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus. Results Analysis of the evidence resulted in 18 recommendations, suggesting there are several effective treatments available for AK. Limitations The analysis informing the recommendations was based on the best available evidence at the time it was conducted. The results of future studies may necessitate a revision of current recommendations. Conclusions Strong recommendations are presented for using ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are presented for the use of photodynamic therapy and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.
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- 2021
26. Guidelines of care for the management of actinic keratosis
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Sue Peschin, Maryam M. Asgari, James E. Sligh, Sameer Malik, Lindsy Frazer-Green, David J. Leffell, Robert P. Dellavalle, Gary Goldenberg, Suzanne M. Connolly, Todd E. Schlesinger, Daniel B. Eisen, Peggy A. Wu, Daniel D. Bennett, and Esther E. Freeman
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medicine.medical_specialty ,Diclofenac ,Ultraviolet protection ,Dermatology ,English language ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Humans ,Intensive care medicine ,Grading (tumors) ,Imiquimod ,business.industry ,Actinic keratosis ,Actinic keratoses ,medicine.disease ,Keratosis, Actinic ,Photochemotherapy ,030220 oncology & carcinogenesis ,Relative risk ,Fluorouracil ,Topical imiquimod ,business - Abstract
Background Actinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet-exposed skin and can progress to keratinocyte carcinoma. Objective This analysis examined the literature related to the management of AK to provide evidence-based recommendations for treatment. Grading, histologic classification, natural history, risk of progression, and dermatologic surveillance of AKs are also discussed. Methods A multidisciplinary Work Group conducted a systematic review to address 5 clinical questions on the management of AKs and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus. Results Analysis of the evidence resulted in 18 recommendations. Limitations This analysis is based on the best available evidence at the time it was conducted. The pragmatic decision to limit the literature review to English language randomized trials may have excluded data published in other languages or limited identification of relevant long-term follow-up data. Conclusions Strong recommendations are made for using ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are made for the use of photodynamic therapy and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.
- Published
- 2021
27. Dermatology COVID-19 Registries
- Author
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Dmitri Wall, Esther E. Freeman, Devon E. McMahon, George J. Hruza, Christopher E.M. Griffiths, Nekma Meah, Grace Chamberlin, Leslie Castelo-Soccio, Haley B. Naik, Alan D. Irvine, Kelly M. Cordoro, Carsten Flohr, Phyllis I. Spuls, Satveer K. Mahil, Michelle A. Lowes, Steven R. Feldman, Irene Lara-Corrales, Catherine H. Smith, Angelo V. Marzano, Rodney Sinclair, Esther A. Balogh, and Lars E. French
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Public health ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Dermatology ,Patient care ,Pandemic ,Global health ,Medicine ,Pediatric dermatology ,business - Abstract
During the COVID-19 pandemic, rapid, real-world evidence is essential for the development of knowledge and subsequent public health response. In dermatology, provider-facing and patient-facing registries focused on COVID-19 have been important sources of research and new information aimed at guiding optimal patient care. The 7 dermatology registries included in this update now include more than 8000 case reports sourced from physicians and patients from countries all over the world.
- Published
- 2021
28. Beyond T Staging in the 'Treat-All' Era: Severity and Heterogeneity of Kaposi Sarcoma in East Africa
- Author
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Michael Kanyesigye, Esther E. Freeman, Naftali Busakhala, Susan Regan, Mwebesa Bwana, Aggrey Semeere, Megan Wenger, Ingrid V. Bassett, Helen Byakwaga, Elyne Rotich, Miriam Laker-Oketta, Kara Wools-Kaloustian, Devon E. McMahon, Matthew Ssemakadde, Philippa Kadama-Makanga, Charles Kasozi, Jeffrey N. Martin, and Job Kisuya
- Subjects
Adult ,Male ,sub-Saharan Africa ,medicine.medical_specialty ,Clinical Sciences ,global health ,HIV Infections ,Kaposi ,Disease ,Severity of Illness Index ,Article ,Rare Diseases ,Disease severity ,Clinical Research ,Virology ,Internal medicine ,medicine ,Advanced disease ,East africa ,Humans ,cancer ,Uganda ,biopsy ,Pharmacology (medical) ,delayed diagnosis ,Stage (cooking) ,Sarcoma, Kaposi ,Neoplasm Staging ,business.industry ,Advanced stage ,HIV ,Kaposi sarcoma ,Sarcoma ,staging ,medicine.disease ,Kenya ,AIDS ,Emerging Infectious Diseases ,Infectious Diseases ,Public Health and Health Services ,Marked heterogeneity ,Female ,Infection ,business - Abstract
BackgroundAlthough many patients with Kaposi sarcoma (KS) in sub-Saharan Africa are diagnosed with AIDS Clinical Trials Group (ACTG) T1 disease, T1 staging insufficiently captures clinical heterogeneity of advanced KS. Using a representative community-based sample, we detailed disease severity at diagnosis to inform KS staging and treatment in sub-Saharan Africa.MethodsWe performed rapid case ascertainment on people living with HIV, aged 18 years or older, newly diagnosed with KS from 2016 to 2019 at 3 clinic sites in Kenya and Uganda to ascertain disease stage as close as possible to diagnosis. We reported KS severity using ACTG and WHO staging criteria and detailed measurements that are not captured in the current staging systems.ResultsWe performed rapid case ascertainment within 1 month for 241 adults newly diagnosed with KS out of 389 adult patients with suspected KS. The study was 68% men with median age 35 years and median CD4 count 239. Most of the patients had advanced disease, with 82% qualifying as ACTG T1 and 64% as WHO severe/symptomatic KS. The most common ACTG T1 qualifiers were edema (79%), tumor-associated ulceration (24%), extensive oral KS (9%), pulmonary KS (7%), and gastrointestinal KS (4%). There was marked heterogeneity within T1 KS, with 25% of patients having 2 T1 qualifying symptoms and 3% having 3 or more.ConclusionMost of the patients newly diagnosed with KS had advanced stage disease, even in the current antiretroviral therapy "treat-all" era. We observed great clinical heterogeneity among advanced stage patients, leading to questions about whether all patients with advanced KS require the same treatment strategy.
- Published
- 2021
29. Monkeypox emerges on a global scale: A historical review and dermatologic primer
- Author
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Joshua S. Bryer, Esther E. Freeman, and Misha Rosenbach
- Subjects
Dermatology - Published
- 2022
30. Skin reactions to COVID-19 vaccines: An American Academy of Dermatology/International League of Dermatological Societies registry update on reaction location and COVID vaccine type
- Author
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Kimberly G. Blumenthal, Lindy P. Fox, Ramie Fathy, Lars E. French, Anisha Tyagi, Esther E. Freeman, George J. Hruza, Qisi Sun, Devon E. McMahon, and Rhea Singh
- Subjects
2019-20 coronavirus outbreak ,Skin reaction ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Medicine ,Dermatology ,business ,Virology - Published
- 2022
31. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases
- Author
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Kimberly G. Blumenthal, Anisha Tyagi, Jules B. Lipoff, Henry W. Lim, Lindy P. Fox, Devon E. McMahon, Danna Moustafa, Seemal R. Desai, Lars E. French, Erin Amerson, Bruce H. Thiers, Esther E. Freeman, George J. Hruza, and Misha Rosenbach
- Subjects
Adult ,Male ,medicine.medical_specialty ,COVID-19 Vaccines ,mRNA ,Dermatology ,registry ,Global Health ,Article ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Pfizer ,vaccine ,medicine ,Humans ,Registries ,Erythema multiforme ,Chilblains ,Adverse effect ,SARS-CoV-2 ,business.industry ,public health ,COVID-19 ,Middle Aged ,medicine.disease ,Morbilliform ,Vaccination ,Delayed hypersensitivity ,Moderna ,030220 oncology & carcinogenesis ,Pityriasis rosea ,Female ,Drug Eruptions ,business ,Shingles - Abstract
Background Cutaneous reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but are not well characterized. Objective To evaluate the morphology and timing of cutaneous reactions after mRNA COVID-19 vaccines. Methods A provider-facing registry-based study collected cases of cutaneous manifestations after COVID-19 vaccination. Results From December 2020 to February 2021, we recorded 414 cutaneous reactions to mRNA COVID-19 vaccines from Moderna (83%) and Pfizer (17%). Delayed large local reactions were most common, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. Forty-three percent of patients with first-dose reactions experienced second-dose recurrence. Additional less common reactions included pernio/chilblains, cosmetic filler reactions, zoster, herpes simplex flares, and pityriasis rosea-like reactions. Limitations Registry analysis does not measure incidence. Morphologic misclassification is possible. Conclusions We report a spectrum of cutaneous reactions after mRNA COVID-19 vaccines. We observed some dermatologic reactions to Moderna and Pfizer vaccines that mimicked SARS-CoV-2 infection itself, such as pernio/chilblains. Most patients with first-dose reactions did not have a second-dose reaction and serious adverse events did not develop in any of the patients in the registry after the first or second dose. Our data support that cutaneous reactions to COVID-19 vaccination are generally minor and self-limited, and should not discourage vaccination.
- Published
- 2021
32. Urticaria and/or angioedema secondary to mRNA COVID-19 vaccines: Updates from a United States case registry
- Author
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Sara Anvari, Upeka Samarakoon, Xiaoqing Fu, Jordan Jaggers, Alexei Gonzalez‐Estrada, Hey Jin Chong, Sara W. Van Meerbeke, Andrej A. Petrov, David A. Khan, Esther E. Freeman, Aleena Banerji, and Kimberly G. Blumenthal
- Subjects
Immunology ,Immunology and Allergy - Published
- 2022
33. Telling the story of intersectional stigma in HIV‐associated Kaposi's sarcoma in western Kenya: a convergent mixed‐methods approach
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Sigrid Collier, Rhea Singh, Aggrey Semeere, Helen Byakwaga, Miriam Laker‐Oketta, Devon E. McMahon, Linda Chemtai, Merridy Grant, Lisa Butler, Laura Bogart, Ingrid V. Bassett, Samson Kiprono, Toby Maurer, Jeffrey Martin, Naftali Busakhala, and Esther E. Freeman
- Subjects
Infectious Diseases ,Public Health, Environmental and Occupational Health ,Humans ,HIV Infections ,Longitudinal Studies ,Kenya ,Sarcoma, Kaposi - Abstract
The experience of stigma can be multifaceted for people with HIV and cancer. Kaposi's sarcoma (KS), one of the most common HIV-associated cancers in sub-Saharan Africa, often presents with visible skin lesions that may put people at risk for stigmatization. In this way, HIV-associated KS is unique, as people with KS can experience stigma associated with HIV, cancer, and skin disease simultaneously. The aim of this study is to characterize the intersectionality of HIV-related, cancer-related and skin disease-related stigma in people living with HIV and KS.We used a convergent mixed-methods approach nested within a longitudinal study of people with HIV-associated KS in western Kenya. Between February 2019 and December 2020, we collected quantitative surveys among all participants and conducted semi-structured interviews among a purposive sample of participants. Quantitative surveys were adapted from the abridged Berger HIV Stigma Scale to assess overall stigma, HIV-related stigma, cancer-related stigma, and skin disease-related stigma. Qualitative data were coded using stigma constructs from the Health Stigma and Discrimination Framework.In 88 semi-structured interviews, stigma was a major barrier to KS diagnosis and treatment among people with HIV-associated KS. Participant's stories of stigma were dominated by HIV-related stigma, more than cancer-related or skin disease-related stigma. However, quantitative stigma scores among the 117 participants were similar for HIV-related (Median: 28.00; IQR: 28.0, 34.0), cancer-related (Median: 28.0; IQR: 28.0, 34.8), and skin disease-related stigma (Median: 28.0; IQR: 27.0, 34.0). In semi-structured interviews, cancer-related and skin disease-related stigma were more subtle contributors; cancer-related stigma was linked to fatalism and skin-related stigma was linked to visible disease. Participants reported resolution of skin lesions contributed to lessening stigma over time; there was a significant decline in quantitative scores of overall stigma in time since KS diagnosis (adjusted β = -0.15, p0.001).This study highlights the role mixed-method approaches can play in better understanding stigma in people living with both HIV and cancer. While HIV-related stigma may dominate perceptions of stigma among people with KS in Kenya, intersectional experiences of stigma may be subtle, and quantitative evaluation alone may be insufficient to understand intersectional stigma in certain contexts.
- Published
- 2022
34. Healthcare Costs and Financial Barriers to Diagnosis and Treatment of People Living with HIV-Associated Kaposi’s Sarcoma in Western Kenya: A Qualitative Analysis
- Author
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Rhea Sing, Sigrid Collier, Aggrey Semeere, Helen Byakwaga, Miriam Laker-Oketta, Devon E. McMahon, Linda Chemtai, Merridy Grant, Lisa M. Butler, Ingrid V. Bassett, Samson Kiprono, Toby Maurer, Jeffrey Martin, Naftali Busakhala, and Esther E. Freeman
- Published
- 2022
35. Stigma in the Diagnosis and Treatment of HIV-associated Kaposi’s Sarcoma
- Author
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Sigrid Collier, Rhea Sing, Aggrey Semeere, Helen Byakwaga, Miriam Laker-Oketta, Devon E. McMahon, Linda Chemtai, Merridy Grant, Lisa M. Butler, Ingrid V. Bassett, Samson Kiprono, Toby Maurer, Jeffrey Martin, Naftali Busakhala, and Esther E. Freeman
- Published
- 2022
36. Developing a Platform for Global Health Dermatology Mentorship and Collaboration
- Author
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Devon E. McMahon, Linda Oyesiku, L.C. Fuller, and Esther E. Freeman
- Subjects
Teledermatology ,medicine.medical_specialty ,business.industry ,Dermatology ,Health professions ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Mentorship ,Alliance ,030220 oncology & carcinogenesis ,Global health ,Neglected tropical diseases ,medicine ,business - Abstract
The International Alliance for Global Health Dermatology (GLODERM) was formed in 2019 with the aim to unite efforts toward skin health, open to members from any health profession, any country, and at any stage of training. This article highlights the case for such an alliance; discusses existing opportunities and gaps in global health dermatology; describes the development of a new international alliance; proposes future directions; and reflects on lessons learned.
- Published
- 2021
37. Urticaria 12 Days After COVID-19 mRNA Booster Vaccination
- Author
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Anna R. Wolfson, Esther E. Freeman, and Kimberly G. Blumenthal
- Subjects
COVID-19 Vaccines ,Urticaria ,SARS-CoV-2 ,Vaccination ,Immunization, Secondary ,COVID-19 ,Humans ,General Medicine ,mRNA Vaccines - Published
- 2022
38. Nodules in a sporotrichoid (lymphangitic) distribution
- Author
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Devon E McMahon, Cristina Thomas, Rhea Singh, and Esther E Freeman
- Subjects
Lymphangitis ,Humans ,General Medicine - Published
- 2022
39. Axial spectral encoding for low-cost confocal endomicroscopy
- Author
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Nachiket Kulkarni, Andrew Masciola, Abhinav Nishant, Kyungjo Kim, Arthur F. Gmitro, Esther E. Freeman, Aggrey Semeere, Miriam Nakalembe, and DongKyun Kang
- Published
- 2022
40. Pernio after COVID‐19 vaccination
- Author
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Paras P Vakharia, Rebecca Vasquez, T Vandergriff, S Lopez, and Esther E. Freeman
- Subjects
2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Vaccination ,MEDLINE ,COVID-19 ,Dermatology ,Virology ,Chilblains ,Research Letter ,Humans ,Medicine ,business - Published
- 2021
41. Identifying gaps in global health dermatology: a survey of GLODERM members
- Author
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W. Rehmus, C van Hees, S A Norton, H Beltraminelli, Erin Amerson, Linda Oyesiku, Esther E. Freeman, Karolyn A. Wanat, Roderick Hay, Aileen Y. Chang, Toby Maurer, Alexia P. Knapp, Carrie L. Kovarik, L.C. Fuller, Victoria L. Williams, Devon E. McMahon, and Amy K. Forrestel
- Subjects
Medical education ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,education ,Medical school ,MEDLINE ,Dermatology ,Global Health ,Article ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Multidisciplinary approach ,Surveys and Questionnaires ,Political science ,Global health ,Health for all ,Humans - Abstract
Global health is a multidisciplinary field with a focus on improving health for all people worldwide. Interest in global health continues to grow, with 24% of U.S. medical students completing global health experiences during medical school.
- Published
- 2021
42. The spectrum of COVID-19–associated dermatologic manifestations: An international registry of 716 patients from 31 countries
- Author
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Henry W. Lim, Lindy P. Fox, Junko Takeshita, Carrie L. Kovarik, Bruce H. Thiers, Devon E. McMahon, Esther E. Freeman, George J. Hruza, Lars E. French, Seemal R. Desai, Jules B. Lipoff, Misha Rosenbach, and Joanna Harp
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Critically ill ,Hospitalized patients ,business.industry ,Incidence (epidemiology) ,MACULAR ERYTHEMA ,Dermatology ,Morbilliform ,Pathophysiology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Purpura ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,In patient ,medicine.symptom ,business ,Mild disease ,Skin Findings - Abstract
Background Coronavirus disease 2019 (COVID-19) has associated cutaneous manifestations. Objective To characterize the diversity of cutaneous manifestations of COVID-19 and facilitate understanding of the underlying pathophysiology. Methods Case series from an international registry from the American Academy of Dermatology and International League of Dermatological Societies. Results The registry collected 716 cases of new-onset dermatologic symptoms in patients with confirmed/suspected COVID-19. Of the 171 patients in the registry with laboratory-confirmed COVID-19, the most common morphologies were morbilliform (22%), pernio-like (18%), urticarial (16%), macular erythema (13%), vesicular (11%), papulosquamous (9.9%), and retiform purpura (6.4%). Pernio-like lesions were common in patients with mild disease, whereas retiform purpura presented exclusively in ill, hospitalized patients. Limitations We cannot estimate incidence or prevalence. Confirmation bias is possible. Conclusions This study highlights the array of cutaneous manifestations associated with COVID-19. Many morphologies were nonspecific, whereas others may provide insight into potential immune or inflammatory pathways in COVID-19 pathophysiology.
- Published
- 2020
43. Delayed large local reactions to Moderna COVID-19 vaccine: A follow-up report after booster vaccination
- Author
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Kimberly G. Blumenthal, Catherine Ahola, Sara Anvari, Upeka Samarakoon, and Esther E. Freeman
- Subjects
Dermatology ,COVID-19 ,Moderna ,delayed hypersensitivity ,mRNA ,dermatology ,injection site reaction ,Moderna arm ,vaccine ,vaccine reaction ,Pfizer ,delayed large local reaction ,booster ,SARS-CoV-2 - Published
- 2022
44. Chilblains and COVID-19-An Update on the Complexities of Interpreting Antibody Test Results, the Role of Interferon α, and COVID-19 Vaccines
- Author
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Qisi Sun and Esther E. Freeman
- Subjects
Chilblains ,COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19 ,Humans ,Interferon-alpha ,Dermatology - Published
- 2021
45. The dynamics of monkeypox transmission
- Author
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Esther E Freeman, Sam Abbott, Brett Kurpiel, and Tochi Okwor
- Subjects
Humans ,Monkeypox ,General Medicine ,Disease Outbreaks - Published
- 2022
46. Varicella‐zoster and herpes simplex virus reactivation post‐COVID‐19 vaccination: a review of 40 cases in an International Dermatology Registry
- Author
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Lars E. French, Grace Chamberlin, Henry W. Lim, Lindy P. Fox, Jules B. Lipoff, Devon E. McMahon, Harry L. Greenberg, Cynthia Lee, Anisha Tyagi, Marlys S. Fassett, Esther E. Freeman, George J. Hruza, Misha Rosenbach, Seemal R. Desai, Kimberly G. Blumenthal, Bruce H. Thiers, and Ramie Fathy
- Subjects
Herpesvirus 3, Human ,2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Dermatology ,medicine.disease_cause ,Herpes Zoster ,Letters To The Editor ,Chickenpox ,Humans ,Simplexvirus ,Medicine ,Registries ,Letter to the Editor ,SARS-CoV-2 ,business.industry ,Vaccination ,COVID-19 ,Herpes Simplex ,medicine.disease ,Virology ,Infectious Diseases ,Herpes simplex virus ,business ,Shingles - Published
- 2021
47. Clinical and Pathologic Correlation of Cutaneous COVID-19 Vaccine Reactions including V-REPP: A Registry Based Study
- Author
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Jules B. Lipoff, Bruce H. Thiers, Esther E. Freeman, Seemal R. Desai, Devon E. McMahon, George J. Hruza, Kimberly G. Blumenthal, Lars E. French, Ramie Fathy, Rosalynn M. Nazarian, William Damsky, Henry W. Lim, Carrie L. Kovarik, Lindy P. Fox, Grace Chamberlin, Anisha Tyagi, and Misha Rosenbach
- Subjects
bullous pemphigoid ,pityriasis rosea ,registry ,Stevens-Johnson syndrome ,papular ,chilblains ,mRNA-1273 ,Zoster ,urticaria ,erythromelalgia ,AZD1222 ,vaccine ,Erythema multiforme ,Registries ,dermatopathology ,medicine.diagnostic_test ,lichen planus ,Pityriasis ,psoriasis ,dermatology ,Moderna ,Dermatopathology ,morbilliform ,medicine.medical_specialty ,Ad26.COV2.S ,COVID-19 Vaccines ,Johnson & Johnson Janssen ,Oxford-AstraZeneca ,Skin Diseases ,Article ,Biopsy ,medicine ,Humans ,pernio ,Chilblains ,dermal hypersensitivity reaction ,delayed large local ,business.industry ,SARS-CoV-2 ,erythema multiforme ,COVID-19 ,Exanthema ,medicine.disease ,Dermatology ,papulosquamous ,Skin biopsy ,Pityriasis rosea ,Histopathology ,pathology ,Pfizer-BioNTech ,BNT162b2 ,business - Abstract
Background Cutaneous reactions after COVID-19 vaccination have been commonly reported; however, histopathologic features and clinical correlations have not been well characterized. Methods We evaluated for a history of skin biopsy all reports of reactions associated with COVID-19 vaccination identified in an international registry. When histopathology reports were available, we categorized them by reaction patterns. Results Of 803 vaccine reactions reported, 58 (7%) cases had biopsy reports available for review. The most common histopathologic reaction pattern was spongiotic dermatitis, which clinically ranged from robust papules with overlying crust, to pityriasis rosea-like eruptions, to pink papules with fine scale. We propose the acronym “V-REPP” (vaccine-related eruption of papules and plaques) for this spectrum. Other clinical patterns included bullous pemphigoid-like (n = 12), dermal hypersensitivity (n = 4), herpes zoster (n = 4), lichen planus-like (n = 4), pernio (n = 3), urticarial (n = 2), neutrophilic dermatosis (n = 2), leukocytoclastic vasculitis (n = 2), morbilliform (n = 2), delayed large local reactions (n = 2), erythromelalgia (n = 1), and other (n = 5). Limitations Cases in which histopathology was available represented a minority of registry entries. Analysis of registry data cannot measure incidence. Conclusion Clinical and histopathologic correlation allowed for categorization of cutaneous reactions to the COVID-19 vaccine. We propose defining a subset of vaccine-related eruption of papules and plaques, as well as 12 other patterns, following COVID-19 vaccination.
- Published
- 2021
48. Evaluation of four chemotherapy regimens for treatment of advanced AIDS-associated Kaposi sarcoma in Kenya: a cost-effectiveness analysis
- Author
-
Esther E Freeman, Nicole C McCann, Aggrey Semeere, Krishna P Reddy, Miriam Laker-Oketta, Helen Byakwaga, Pamela P Pei, Maya E Hajny Fernandez, Samson Kiprono, Naftali Busakhala, Jeffery N Martin, Toby Maurer, Ingrid V Bassett, Kenneth A Freedberg, and Emily P Hyle
- Subjects
Acquired Immunodeficiency Syndrome ,Bleomycin ,Paclitaxel ,Vincristine ,Cost-Benefit Analysis ,Humans ,HIV Infections ,General Medicine ,Kenya ,Sarcoma, Kaposi ,Etoposide - Abstract
The most effective treatment for advanced AIDS-associated Kaposi sarcoma is paclitaxel or pegylated liposomal doxorubicin (PLD); neither is routinely used in sub-Saharan Africa due to limited availability and high cost. We examined the clinical impact, costs, and cost-effectiveness of paclitaxel or PLD in Kenya, compared with etoposide or bleomycin-vincristine.In this study, we use the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-International Model to project clinical outcomes and costs among people living with HIV and advanced Kaposi sarcoma on antiretroviral therapy. We compared four different treatment strategies: etoposide, bleomycin-vincristine, paclitaxel, or PLD. We derived cohort characteristics and costs from the Kenyan Academic Model for Providing Access to Healthcare network, and adverse events, efficacy, and mortality from clinical trials. We projected model outcomes over a lifetime and included life expectancy, per-person lifetime costs, and incremental cost-effectiveness ratios (ICERs). We conducted budget impact analysis for 5-year total costs and did deterministic and probabilistic sensitivity analyses to evaluate the effect of uncertainty in input parameters.We found that paclitaxel would be more effective than bleomycin-vincristine and would increase life expectancy by 4·2 years per person. PLD would further increase life expectancy by 0·6 years per person. Paclitaxel would be the most cost-effective strategy (ICER US$380 per year-of-life-saved compared with bleomycin-vincristine) and would remain cost-effective across a range of scenarios. PLD would be cost-effective compared with paclitaxel if its price were reduced to $100 per cycle (base case $180 per cycle). Implementing paclitaxel instead of bleomycin-vincristine would save approximately 6400 life-years and would increase the overall 5-year Kenyan health-care costs by $3·7 million; increased costs would be primarily related to ongoing HIV care given improved survival.Paclitaxel would substantially increase life expectancy and be cost-effective compared with bleomycin-vincristine for advanced AIDS-associated Kaposi sarcoma in Kenya and should be the standard of care. PLD would further improve survival and be cost-effective with a 44% price reduction.US National Institutes of Health and Massachusetts General Hospital.For the Swahili translation of the abstract see Supplementary Materials section.
- Published
- 2021
49. 25 Years of Kaposi Sarcoma Herpesvirus: Discoveries, Disparities, and Diagnostics
- Author
-
Esther E. Freeman, Devon E. McMahon, and Toby Maurer
- Subjects
Cancer Research ,Oncology ,business.industry ,Commentaries ,Herpesvirus 8, Human ,MEDLINE ,Humans ,Medicine ,Sarcoma ,business ,medicine.disease ,Bioinformatics ,Sarcoma, Kaposi - Published
- 2020
50. Subepidermal blistering eruptions, including bullous pemphigoid, following COVID-19 vaccination
- Author
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Noel Turner, Lindy P. Fox, Devon E. McMahon, Ramie Fathy, Monica N. Valentin, Mary M. Tomayko, Ohara Aivaz, Tena Rallis, William Damsky, and Esther E. Freeman
- Subjects
2019-20 coronavirus outbreak ,medicine.medical_specialty ,Pemphigoid ,Subepidermal blistering ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Immunology ,Vaccination ,Disease Management ,medicine.disease ,Dermatology ,Disease susceptibility ,Blister ,Correspondence ,Pemphigoid, Bullous ,Immunology and Allergy ,Medicine ,Humans ,Bullous pemphigoid ,Disease Susceptibility ,business - Published
- 2021
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