Original article
Genital psoriasis is associated with significant impairment in quality of life and sexual functioning

Preliminary results of this study were presented in poster format at the International Investigative Dermatology Meeting, Edinburgh, Scotland, May 8-11, 2013.
https://doi.org/10.1016/j.jaad.2015.02.1127Get rights and content

Background

Genital involvement has significant psychosexual implications for psoriasis patients.

Objective

This study was designed to ascertain factors associated with the development of genital psoriasis and its impact on quality of life and sexual functioning.

Methods

This was an observational, multicenter study of 354 consecutive psoriasis patients.

Results

One hundred thirty-four patients (38%) had current genital involvement while 224 (63%) had a current and/or previous history of genital involvement. Eighty-seven percent reported itch, 39% pain, 42% dyspareunia, 32% a worsening of their genital psoriasis after intercourse, and 43% a decreased frequency of intercourse. Younger age of onset of psoriasis, male sex, more severe disease, and involvement of the scalp, flexures, and nails were associated with the presence of genital disease. There was no association with circumcision or obesity. Patients with genital psoriasis had more impairment in quality of life and sexual health as determined by the Dermatology Life Quality Index (P < .0001), the Center for Epidemiological Studies-Depression Scale (P = .01), and the Relationship and Sexuality Scale (P < .0001).

Limitations

This was a descriptive study from 2 tertiary referral centers where patients were likely to have more severe psoriasis.

Conclusion

This study highlights the high prevalence of genital psoriasis and its profound impact on quality of life and sexual health.

Section snippets

Methods

This was an observational, multicenter study of 354 consecutive adult psoriasis patients conducted in, Dallas, Texas and Dublin, Ireland between September 2010 and July 2012. Ethical approval was granted by each institute. All patients gave informed, written consent. Patient demographics, psoriasis, and medical history were recorded. Psoriasis clinical severity was measured using both the Psoriasis Area and Severity Index (PASI) and percentage body surface area (BSA) affected.5 Comprehensive

Baseline characteristics and psoriasis severity

A total of 354 patients were recruited to the study. Baseline demographics and clinical characteristics are summarized in Table I. Sixty-two percent of patients were taking systemic or biologic treatments. The only statistical differences between the 2 groups were a higher frequency of circumcision in the Dallas group and a higher proportion of males in the Dublin group (Table II).

Prevalence and clinical characteristics of genital involvement

One hundred thirty-four patients (38%) had current genital involvement, and 224 patients (63%) reported having

Discussion

The psychosocial impact of psoriasis often causes more distress than its physical symptoms, and the perception of stigmatization has a detrimental impact on social functioning and self-image.1, 2, 3, 10, 11, 12, 13 The peak onset of psoriasis is from 15 to 30 years of age, when issues pertaining to sexual health are more likely to have a negative effect on creating and maintaining interpersonal relationships.14 Many dermatologists do not routinely inquire or examine for the presence of genital

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  • Cited by (0)

    Ethical approval was granted by Baylor Research Institute, Dallas (IRB 009-307) and the Ethics and Medical Research committee of St Vincent's University Hospital, Dublin.

    Funding sources: None.

    Disclosures appear at the end of this article.

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