title: Distribution pattern of psoriasis affects sexual function in moderate to severe psoriasis: a prospective case series study.
abstract: BACKGROUND
  Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relationship. However, beyond genital psoriasis, the importance of the distribution pattern of the disease has not been considered.
  
  
  OBJECTIVE
  To investigate the role of the distribution pattern of psoriasis in sexual dysfunction.
  
  
  METHODS
  A prospective case series study was carried out on 133 patients with moderate to severe psoriasis.
  
  
  METHODS
  The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index.
  
  
  RESULTS
  Forty-four women (mean age 42.0 ± 14.1) and 79 men (mean age 47 ± 11.7) were included in the study. Psoriasis lesions on abdomen, genitals, lumbar region, and buttocks in women and chest, genitals, and buttocks in men were associated with an increase in sexual dysfunction. Multivariate logistic regression analysis showed that the involvement of these specific areas may be independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis.
  
  
  CONCLUSIONS
  This is the first study identifying body areas other than genitals as potentially related to sexual dysfunction in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when deciding on treatment for psoriasis patients.
authors.affiliation: Department of Dermatology, University Hospital Granada, Granada, Spain; Department of Dermatology, Complejo Hospitalario Torrecárdenas, Almería, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Molina-Leyva
authors.forename: Ana
authors.initials: A
authors.lastname: Almodovar-Real
authors.forename: Jose C
authors.initials: JC
authors.lastname: Ruiz-Carrascosa
authors.forename: Ramon
authors.initials: R
authors.lastname: Naranjo-Sintes
authors.forename: Salvio
authors.initials: S
authors.lastname: Serrano-Ortega
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Jimenez-Moleon
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001828:Body Image; D003863:Depression / Q000209:etiology; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications / Q000523:psychology*; D005832:Genital Diseases, Male / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; Epidemiological Study; Psoriasis/Complications; Psychological; Sexual Dysfunctions