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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. [ABSTRACT FROM AUTHOR]

The author discusses the possible influence of sleep distress as an adjuvant factor that triggers systemic lupus erythematosus (SLE) activity. Topics include role of sleep in inflammatory response and the modulation of cytokine levels, how sleep may influence lupur erythematosus, and possible link between sleep loss and an increased risk of glomerulonephritis due to dysregulation of the immune system and the higher levels of interleukin (IL)-6 and IL-10.

Atopic dermatitis (AD) is one of the most common pediatric dermatologic disorders and is associated with an increased risk of recurrent bacterial and viral cutaneous infections, such as impetigo, the most common bacterial infection in children. AD may impair patient quality of life in a number of ways, one of which is its impact on sleep. The way that the condition affects sleep has not yet been fully elucidated; it is clear that the symptoms of the disease such as pruritus and scratching can affect sleep but other factors, such as changes in the immunological system related to the disease can also have an effect. We argue that this relationship may be bi-directional, with changes to the skin barrier (barrier dysfunction, alterations in its microbiome and oxidative stress) and immunological function caused by the condition impairing sleep and leading to imbalanced inflammatory pathways that exacerbate AD and other associated conditions such as impetigo. We highlight the need for further studies to investigate this correlation between AD and sleep to make the role of this relationship clearer., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)