Esther E. Freeman

Esther Ellen Freeman (born 1979) is an American physician who is an Assistant Professor of Dermatology at the Harvard Medical School and Director of Global Health Dermatology at Massachusetts General Hospital. Her research considers HIV infection with AIDS-defining malignancies, including Kaposi's sarcoma. During the COVID-19 pandemic Freeman established the American Academy of Dermatology register of COVID-19 skin complaints, through which she identified the novel symptom of COVID toes.

Esther Ellen Freeman
Born1979 (age 43–44)
Alma mater
Scientific career
Institutions
ThesisThe role of herpes simplex virus Type 2 in the spread and control of HIV in four Sub-Saharan African Cities (2006)

Early life and education

Freeman attended Milton Academy.[1] As a child she was a competitive skier, and competed in the national championships at the age of twelve.[1][2] By the age of fifteen Freeman was a member of the United States freestyle skiing team.[1] Freeman earned her undergraduate degree at Dartmouth College.[1] Throughout her college career she skied in World Cup competitions and was a member of the Dartmouth sailing team.[1] During her studies at Dartmouth, Freeman spent time in Kenya and Mexico. In 2002 she was selected as a Marshall Scholar, and moved to the United Kingdom to complete her graduate studies.[1] She was a graduate student at the London School of Hygiene & Tropical Medicine, where she studied HIV dermatology.[3] After completing her doctorate Freeman returned to the United States, where she started a medical degree at Harvard Medical School, and soon after completed her specialist training in dermatology.

Research and career

In 2011 Freeman began work with the World Health Organization, drafting guidelines on how to treat skin conditions that were associated with HIV in the developing world.[4] For these efforts she was awarded the 2012 American Academy of Dermatology Members Making a Difference Award.[5]

In 2013 Freeman was appointed Director of Global Health Dermatology at the Massachusetts General Hospital. Here she continued to investigate HIV dermatology, with a particular focus on Kaposi's sarcoma.[6] She serves on the leadership team of the International Alliance of Global Health Dermatology.[7]

Leadership during the COVID-19 pandemic

Freeman is a member of the American Academy of Dermatology task force on coronavirus disease.[8] As part of this effort, she launched and helped to compile a registry of skin complaints of COVID-19 patients.[9][10][11] Freeman had expected that coronavirus patients would present with viral rashes. By April 2020 it emerged that around half of the patients who presented with dermatological manifestations of coronavirus disease had so-called "COVID toes".[8] COVID toes are pinkish-reddish lesions that can turn purple as the coronavirus disease progresses (akin to pernio or chilblains),[12] but are distinct from purpura fulminans.[8][13] They typically last for two to three weeks and can without specific treatment.[14] The physiology behind COVID toes is not understood, but could occur due to inflammation of the toe tissue, inflammation of the blood vessel wall or small blood clots on the inside of the blood vessel.[8][15] Freeman has shown that even asymptomatic carriers can present with COVID toes, and that most patients in the dermatological register with COVID toe are in their 20s and 30s.[8] She has said that if people have these symptoms have no other cause to have such toes, they should try and get a COVID-19 test.[16][17] Lindy Fox, a dermatologist in San Francisco, reported that despite it not being the right time of year for chilblains, she was seeing "clinics filled with people coming in with new toe lesions".[17]

Selected publications
  • Freeman, Esther E; Weiss, Helen A; Glynn, Judith R; Cross, Pamela L; Whitworth, James A; Hayes, Richard J (2006). "Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies". AIDS. 20 (1): 73–83. doi:10.1097/01.aids.0000198081.09337.a7. ISSN 0269-9370. PMID 16327322. S2CID 37946948.[18]
  • Freeman, Esther E.; Orroth, Kate K.; White, Richard G.; Glynn, Judith R.; Bakker, Roel; Boily, Marie-Claude; Habbema, Dik; Buvé, Anne; Hayes, Richard (August 1, 2007). "Proportion of new HIV infections attributable to herpes simplex 2 increases over time: simulations of the changing role of sexually transmitted infections in sub-Saharan African HIV epidemics". Sexually Transmitted Infections. 83 (suppl 1): i17–i24. doi:10.1136/sti.2006.023549. ISSN 1368-4973. PMID 17405782. S2CID 30331411.[19]
  • White, R. G.; Glynn, J. R.; Orroth, K. K.; Freeman, E. E.; Bakker, R.; Weiss, H. A.; Kumaranayake, L.; Habbema, J. D. F.; Buvé, A.; Hayes, R. J. (2008). "Male circumcision for HIV prevention in sub-Saharan Africa: who, what and when?". AIDS. doi:10.1097/QAD.0b013e32830e0137. OCLC 714926474.[20]

References
  1. "Esther Freeman named 2002 Marshall Scholarship Winner". Milton Academy. December 6, 2001. Retrieved January 5, 2020.
  2. "FREEMAN Esther - Athlete Information". www.fis-ski.com. Retrieved May 1, 2020.
  3. Freeman, Esther; University of London (2006). The role of herpes simplex virus Type 2 in the spread and control of HIV in four Sub-Saharan African Cities. London: University of London. OCLC 500303273.
  4. "Global Health Dermatology". Massachusetts General Hospital. Retrieved May 1, 2020.
  5. "Members Making a Difference Award". www.aad.org. Retrieved May 1, 2020.
  6. "2013 Award and Grant Recipients". American Skin Association. Retrieved May 1, 2020.
  7. "Introducing the International Alliance for Global Health Dermatology (GLODERM)". ILDS. March 29, 2019. Retrieved May 1, 2020.
  8. Rodriguez, Adrianna. "Doctors find more cases of 'COVID toes' in dermatological registry. Here's what they learned". USA TODAY. Retrieved May 1, 2020.
  9. "COVID-19 dermatology registry". www.aad.org. Retrieved May 1, 2020.
  10. "'Frostbite' toes and other peculiar rashes may be signs of hidden coronavirus infection, especially in the young". The Seattle Times. April 29, 2020. Retrieved May 1, 2020.
  11. "AAD Registry for Skin Manifestations of COVID-19: Q&A With Dr Freeman". The Dermatologist. Retrieved May 1, 2020.
  12. "Dermatology expert weighs in on 'COVID toes,' tracking dermatologic symptoms of COVID-19". www.healio.com. April 24, 2020. Retrieved May 1, 2020.
  13. Pawlowski, A. "'COVID toes' often appear in patients with no other symptoms". NBC News. Retrieved May 1, 2020.
  14. "'Frostbite' toes, skin rashes may be sign of coronavirus". The Washington Post. April 29, 2020. Retrieved May 1, 2020.
  15. "Are 'covid toes' a real symptom of the coronavirus?". LiveScience. April 30, 2020. Retrieved May 1, 2020.
  16. Lee, Yeji Jesse. "'COVID toes' might be the latest unusual sign that people are infected with the novel coronavirus". Business Insider. Retrieved May 1, 2020.
  17. Rabin, Roni Caryn (May 1, 2020). "What Is 'Covid Toe'? Maybe a Strange Sign of Coronavirus Infection". The New York Times. ISSN 0362-4331. Retrieved May 1, 2020.
  18. Freeman, Esther E; Weiss, Helen A; Glynn, Judith R; Cross, Pamela L; Whitworth, James A; Hayes, Richard J (2006). "Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies". AIDS. 20 (1): 73–83. doi:10.1097/01.aids.0000198081.09337.a7. ISSN 0269-9370. PMID 16327322. S2CID 37946948.
  19. Freeman, Esther E.; Orroth, Kate K.; White, Richard G.; Glynn, Judith R.; Bakker, Roel; Boily, Marie-Claude; Habbema, Dik; Buvé, Anne; Hayes, Richard (August 1, 2007). "Proportion of new HIV infections attributable to herpes simplex 2 increases over time: simulations of the changing role of sexually transmitted infections in sub-Saharan African HIV epidemics". Sexually Transmitted Infections. 83 (suppl 1): i17–i24. doi:10.1136/sti.2006.023549. ISSN 1368-4973. PMID 17405782.
  20. White, R. G.; Glynn, J. R.; Orroth, K. K.; Freeman, E. E.; Bakker, R.; Weiss, H. A.; Kumaranayake, L.; Habbema, J. D. F.; Buvé, A.; Hayes, R. J. (2008). "Male circumcision for HIV prevention in sub-Saharan Africa: who, what and when?". AIDS. doi:10.1097/QAD.0b013e32830e0137. OCLC 714926474.
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