title: Genital psoriasis is associated with significant impairment in quality of life and sexual functioning.
abstract: 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).
  
  
  CONCLUSIONS
  This was a descriptive study from 2 tertiary referral centers where patients were likely to have more severe psoriasis.
  
  
  CONCLUSIONS
  This study highlights the high prevalence of genital psoriasis and its profound impact on quality of life and sexual health.
authors.affiliation: Department of Dermatology, Baylor University Medical Center, Dallas, Texas; Department of Medical Education, Texas A&M Health Science Center, Dallas, Texas. Electronic address: caitrionaryan80@gmail.com.
authors.forename: Caitriona
authors.initials: C
authors.lastname: Ryan
authors.affiliation: Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Muriel
authors.initials: M
authors.lastname: Sadlier
authors.affiliation: Department of Quantitative Sciences, Baylor Health Care System, Dallas, Texas.
authors.forename: Edward
authors.initials: E
authors.lastname: De Vol
authors.affiliation: Department of Dermatology, Baylor University Medical Center, Dallas, Texas.
authors.forename: Mahir
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Dermatology, Baylor University Medical Center, Dallas, Texas.
authors.forename: Amanda Abramson
authors.initials: AA
authors.lastname: Lloyd
authors.affiliation: Department of Medical Education, Texas A&M Health Science Center, Dallas, Texas.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Day
authors.affiliation: Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Aoife
authors.initials: A
authors.lastname: Lally
authors.affiliation: Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Kirby
authors.affiliation: Department of Dermatology, Baylor University Medical Center, Dallas, Texas; Department of Medical Education, Texas A&M Health Science Center, Dallas, Texas.
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology / Q000523:psychology; D005832:Genital Diseases, Male / Q000209:etiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D018434:Sickness Impact Profile; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents
keywords: depression; genital psoriasis; psoriasis; quality of life; sexual function; topical therapy