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

      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.

      Key words

      Abbreviations used:

      BSA (body surface area), CES-D (Center for Epidemiological Studies Depression Scale), DLQI (Dermatology Life Quality Index), OR (odds ratio), PASI (Psoriasis Area and Severity Index), QOL (quality of life), RLSS (Relationship and Sexuality Scale)
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