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

Abstract

Genital involvement has significant psychosexual implications for psoriasis patients. This study was designed to ascertain factors associated with the development of genital psoriasis and its impact on quality of life and sexual functioning. This was an observational, multicenter study of 354 consecutive psoriasis patients. 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). This was a descriptive study from 2 tertiary referral centers where patients were likely to have more severe psoriasis. This study highlights the high prevalence of genital psoriasis and its profound impact on quality of life and sexual health.