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Papers by anamaria facina

Journal of Clinical Sleep Medicine

None Ichthyosis, as a debilitating disease, can cause significant physical and psychological dama... more None Ichthyosis, as a debilitating disease, can cause significant physical and psychological damage to children and their families, which also comprehends sleep impairment. We call attention to the importance of evaluating sleep complaints in these patients, given the scarcity of studies on this subject. As the disease commonly results in severe skin injury, it can affect social relationships and the life and sleep quality of the individuals, leading to significant psychological damage that can persist throughout their lives.

Sleep

Introduction Non-melanoma skin cancer (NMSC) is highly prevalent in renal transplant recipients (... more Introduction Non-melanoma skin cancer (NMSC) is highly prevalent in renal transplant recipients (RTR), due to the immunosuppressive effects of anti-rejection therapy after transplantation. Sleep disturbances can impair the immune system and enhance the repercussions of oxidative stress, which may play an important role in the carcinogenesis pathways. This survey aimed to compare data on quality of life and sleep in RTR with and without NMSC in a dermatology service. Methods The study comprised 126 individuals, distributed in the following groups: RTR with NMSC (n=42), RTR without NMSC (n=43) and healthy controls (n=41). Participants answered a set of questionnaires, including the WHOQOL-bref, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the Berlin Respiratory Disorder questionnaire (BRD). Results The proportion of men were significantly higher among RTR (p=0.034). No statistically significant differences were observed regarding age, body mass index (BMI...

International Journal of Dermatology

Journal of Paediatrics and Child Health, 2020

Journal of Cosmetic Dermatology, 2022

Although rosacea is classically considered a skin disorder, recent evidence shows that it is emer... more Although rosacea is classically considered a skin disorder, recent evidence shows that it is emerging as a systemic vascular disease. The classical symptoms of burning, intense erythema and flushing could be related with several systemic and metabolic comorbidities. We highlight the role of sleep disturbance as a possible trigger for rosacea, which could be explained by the inflammatory and stressful conditions that can be produced by poor sleep. In particular, we call attention to obstructive sleep apnea (OSA), a common multisystemic sleep disorder; it could be linked with rosacea in the context of the metabolic syndrome, which in turn is frequently associated with OSA. Obstructive sleep apnea may be accompanied by autonomic system activation and catecholamine release, which can aggravate rosacea. Poor sleep, resulting from any underlying cause, can have a range of effects including immunological modulation and intrinsic cutaneous changes (such as the impairment of skin barrier defense and changes in the skin microbiome), that may trigger rosacea. Further studies on this subject could provide more evidence on these relationships, and help to improve the patients' quality of life and management of this uncomfortable and potentially severe condition.

Sleep and Breathing, 2021

Sleep disorders are known to be related to autoimmune diseases due to the inflammatory and immuno... more Sleep disorders are known to be related to autoimmune diseases due to the inflammatory and immunological imbalance induced by or aggravating poor sleep [1]. In this context, we are writing to discuss a relationship that needs to be more clearly understood, that between obstructive sleep apnea (OSA)-a widely prevalent sleep breathing disorder [2]and scleroderma-an autoimmune disease that can affect breathing through a number of mechanisms, including lung fibrosis. We highlight pathological and immunological features that both diseases might have in common, and which warrant further clarification. Scleroderma is an autoimmune disease that affects collagen and can present as a restricted dermatological condition, characterized by thickening of the skin, or as a systemic syndrome that evolves with a more severe clinical outcome. This systemic condition can be accompanied by significant collagen fibrosis that affects several organs beyond the skin, such as the esophagus, heart, and lungs, and carries with it great potential for health complications [1, 3], including impaired breathing that can worsen a pre-existing OSA. Autoimmune and inflammatory diseases may lead to the impairment of sleep quality and a decrease in quality of life as a whole. In the case of scleroderma, it can cause lung complications, which can be manifested by interstitial lung disease and pulmonary hypertension, as well as restrictive-ventilatory limitation and anatomic changes in the upper airways due to

The Journal of clinical and aesthetic dermatology, 2020

Dermatologic Therapy, 2021

Cutaneous homeostasis can be modulated by sleep. Although there is little evidence about the effi... more Cutaneous homeostasis can be modulated by sleep. Although there is little evidence about the efficacy of medications topically applied in the morning compared to those administered in the evening, they are commonly prescribed to be used overnight. Poor sleep may affect the tegument, but its repercussion on dermatological therapy is not clear. This communication aims to carry out an overview on the relationship between sleep and the skin, particularly in respect of the effectiveness of topical substances during the night versus the day; and the possible impact of sleep dysregulation on these treatments. Features related to this external organ, involving hydration, blood flow, and the permeability of the superficial barrier have physiological variations in sleep period. Our hypothesis is that sleep loss could alter drug absorption in the dermis and impair the success of the treatment. This can depend on the integrity of the mechanical skin barrier, and the enzymatic process after drug penetration, which may be influenced by the circadian rhythm. We raise the role of sleep disturbance in relation to skin aging and the cutaneous microbiota. The organ integrity and local immunology can be guided by sleep distress, which can modify the control of dermatological diseases. Future comparative analyses are warranted to explore the possible changes of the integumentary system influenced by circadian rhythm, and interference in response to topical dermal treatments. We emphasize the importance of sufficient sleep to improve the clinical management of several dermatosis and cosmetic complaints that need percutaneous therapeutics.

Journal of Cosmetic Dermatology, 2021

Telogen effluvium (TE), a common hair disease, is supposed to be related to stress, which could b... more Telogen effluvium (TE), a common hair disease, is supposed to be related to stress, which could be secondary to poor sleep. We call attention to the current COVID‐19 pandemic, that is leading to an increase in the prevalence of sleep disturbances, and as a consequence, higher states of stress and anxiety, which are possible triggers for TE. In parallel, trichodynia is a sensorial symptom that is commonly related with hair diseases, including TE. We argue that substance P, a neuropeptide that has participation in the neuroinflammation and in the sleep regulation, may play a possible role in this scalp paresthesia. We suggest that there may be an association between this substrate and sleep, which can aggravate trichodynia and TE. Further studies on this subject could provide more evidence on these relationships, and help to improve the patients’ quality of life and management of the condition.

Skin Research and Technology, 2021

Inflammatory Bowel Diseases, 2021

Archives of Women's Mental Health, 2021

To the Editor, Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in the... more To the Editor, Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in the premenopausal female population, affecting women in the reproductive stage in a variable range from 4.8 to 15%. (Vgontzas et al. 2001; Mokhlesi et al. 2012; Azziz et al. 2004; Franik et al. 2016; Rosenfield and Ehrmann 2016) A diagnosis of PCOS can be made when at least 2 out of 3 of the following criteria are met: hyperandrogenism (clinically and/or biochemically), ovulatory dysfunction (including menstrual dysfunction, such as oligo-amenorrhea and oligoanovulation), and polycystic ovarian morphology. (Junqueira et al. 2003; Azziz et al. 2016; Rosenfield and Ehrmann 2016). Its pathogenesis involves an increase in LH-releasing hormone, potentializing its action in the ovarian theca and stroma layers. This produces a consequent inhibition of androgen aromatization into estrogen in the granulosa layer, resulting in a hormonal imbalance and clinical hyperandrogenism (Vgontzas et al. 2001; Rosenfield and Ehrmann 2016) Consequently, estrogen levels could be higher due to the extra-glandular aromatization of these circulating androgens. (Vgontzas et al. 2001; Nacul et al. 2003) This pathophysiology may be manifested by insulin resistance and hyperinsulinemia in up to 75% of affected patients. (Vgontzas et al. 2001; Junqueira et al. 2003) Obesity is a very common finding in this syndrome, although it is not a diagnostic criterion. (Hachul et al. 2019) Women with PCOS have enhanced prevalence of overweight and obesity, ranging from 50 to 80% when compared with women without this gynecologic endocrinopathy. (Mokhlesi et al. 2012; Lim et al. 2012; Wang et al. 2018). Polycystic ovary syndrome can lead to fertility disorders, metabolic disturbances, and psychological implications, especially when hyperandrogenism is manifested at a high clinical stage of the condition. (Vgontzas et al. 2001; Azziz et al. 2016) Another important factor that should be highlighted in the context of this disorder is the role of sleep. Sleep disturbances in women with PCOS may be triggered by several factors beyond the organic issues. These include psychological and social complaints that converge to decreased quality of life. Reduced self-esteem related to body image, less social support, unhealthy habits, and poor mental health (that may lead to anxiety and depression) are key factors that may contribute to sleep disorders in PCOS women. (Fernandez et al. 2018; Azizi-Kutenaee et al. 2020) Aging, increased weight/ body mass index, and endocrine dysregulation may enhance the risk to develop sleep disturbance in PCOS patients, (Sam and Ehrmann 2019) which may be considered as a bidirectional relationship, (Fernandez et al. 2018). Although sociodemographic aspects, such as economic class, education, professional life, and geographic localization could be associated with variable sleep quality, there is a lack of studies that approach these sleep-related parameters in relation to PCOS. More studies on this subject could provide relevant data to develop a better understanding of the role of sleep in this syndrome, beyond the biological features. As sleep could be impaired due to hormonal imbalance, the sleep pattern of PCOS women should be evaluated. Sleep duration, difficulty in initiating or maintaining sleep, and early awakening are some of sleep disturbances that may * Anamaria S. Facina dermatologista@hotmail.com

International Journal of Dermatology, 2020

asis is easily misdiagnosed as acne, although this patient is a healthy man without any history o... more asis is easily misdiagnosed as acne, although this patient is a healthy man without any history of sexual contact before the onset of eruption and any form of local tissue damage. Repetitive fungal micrography is necessary to exclude fungal infection. Due to the increase in Candida carriage in healthy individuals, we think that laboratory examination should be combined with clinical features to make the accurate diagnosis.

World Journal of Pediatrics, 2020

Journal of Clinical Sleep Medicine, 2019

Our studies are supported by the Associação Fundo de Incentivo à Pesquisa (AFIP). S.T. and M.L.A.... more Our studies are supported by the Associação Fundo de Incentivo à Pesquisa (AFIP). S.T. and M.L.A. received CNPq fellowships. No funding or sponsorship was received for the publication of this letter. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The authors declare no conflicts of interest.

Journal of Skin and Stem Cell, 2020