Genital Psoriasis Negatively Impacts Quality of Life and Sexual Function Interview with: Caitriona Ryan, MD Baylor University Medical Center, Interview with:
Caitriona Ryan, MD

Baylor University Medical Center, Dallas

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Ryan: Psoriasis is a common, chronic, inflammatory disorder of the skin which has a considerable impact on social functioning and personal relationships. Genital involvement can have devastating psychosexual implications for psoriasis patients. In a study examining the stigmatization experience in psoriasis patients, involvement of the genitalia was found to be the most relevant, regardless of the overall psoriasis severity. Although sexual function is an integral component of quality of life, dermatology-specific and psoriasis-specific scales largely neglect the impact of disease on sexual health. Despite major advances in other aspects of psoriasis research, there has been little emphasis in recent times on the identification and treatment of genital psoriasis and few studies have examined predisposing risk factors, phenotypical associations or its impact on quality of life and sexual functioning.

This study was designed to examine the prevalence and nature of genital involvement in patients with psoriasis, to ascertain risk factors for the development of genital psoriasis, to determine the impact of genital disease on quality of life and sexual functioning, and to assess patient satisfaction with current topical treatments for genital psoriasis.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Ryan: Genital psoriasis in our patient cohort contributed significantly to the burden of disease. The prevalence of current genital psoriasis was high at 38%, while approximately two-thirds of patients reported ever having genital involvement. A significant proportion of patients reported itch, pain, dyspareunia, worsening of their genital psoriasis after intercourse and a decreased frequency of intercourse. Patients with genital psoriasis had more impairment in quality of life and sexual health as determined by the Dermatology Life Quality Index, the Center for Epidemiological Studies-Depression Scale and the Relationship and Sexuality Scale .

It has been shown that few dermatologists routinely examine for the presence of genital disease, and if present, patients are seldom questioned or counseled about its effect on their quality of life. Likewise, a significant number of patients “hide” their genital psoriasis from both their dermatologist and their sexual partner.

Hopefully the important findings of this study will heighten awareness about the prevalence of genital involvement together with the considerable psychosocial and psychosexual morbidity associated with genital disease. Dermatologists should systematically screen all psoriasis patients in a sensitive fashion for the presence of genital involvement and its impact on their sexual health and relationships, while tailoring appropriate therapy to their patients.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Ryan: There is a great need for more effective therapies for genital psoriasis. Controlled studies are necessary to adequately assess the impact of topical, systemic and biologic treatments on genital psoriasis. We have shown the value of the genital PASI and the RLSS scale in quantifying the objective severity of genital disease and the patient-reported psychosexual burden of genital involvement. These could be valuable instruments for use in drug trials of new targeted psoriasis therapies, which, to date, have failed to specifically measure efficacy in treating genital disease. We hope that the results of this study will encourage drug companies and drug regulatory agencies to assess the efficacy of psoriasis therapies in the genital area when designing future clinical trials.


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

Caitriona Ryan, Muriel Sadlier, Edward De Vol, Mahir Patel, Amanda Abramson Lloyd, Antoinette Day, Aoife Lally, Brian Kirby, Alan Menter

Publication stage: In Press Corrected Proof
Journal of the American Academy of Dermatology
Accepted: February 18, 2015; Published Online: March 30, 2015 Interview with: Caitriona Ryan, MD (2015). Genital Psoriasis Negatively Impacts Quality of Life and Sexual Function 

Last Updated on June 4, 2015 by Marie Benz MD FAAD