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Genital psoriasis: high prevalence, often underdiagnosed

Presented by
Dr Toni Klein, University Medical Center Hamburg-Eppendorf, Germany
EADV 2022
According to a cross-sectional survey of patients in the German PsOBest registry, genital psoriasis or psoriasis in other areas of sexual interest is very common. Affected patients often suffer from sexual dysfunction but rarely discuss this problem with their dermatologist.

The reported prevalence of genital psoriasis or psoriasis in other areas of sexual interest in individuals already diagnosed with psoriasis varies widely in the literature (17–64%) [1‒4]. Dr Toni Klein (University Medical Center Hamburg-Eppendorf, Germany) wished to further explore the prevalence of genital psoriasis and its impact on patients’ sexual life [5].

A cross-sectional survey was conducted by sending questionnaires to a random sample of patients registered in the PsOBest registry (NCT01848028) in Germany. Included in the questionnaires were the Genital Psoriasis Symptom Scale (GPSS), which evaluates the severity of 8 genital psoriasis symptoms and the Genital Psoriasis Sexual Impact Scale (GPSIS), which assesses whether patients avoid sexual activity because of genital psoriasis and level of worsening of genital psoriasis symptoms following sexual activity. Moreover, the researchers included questions exploring both generic and psoriasis-specific reasons for sexual impairment (RSI).

From the 2,010 questionnaires that were sent out, the team received 811 responses (40.3%) and analysed 795 (39.6%). Of these, 41.9% were filled in by women, 51.6% by men, and 6.5% did not report their gender. The mean age at onset of psoriasis was 26.6 years and the mean age for the onset of genital psoriasis was 35.0 years, and for psoriasis in other areas of sexual interest 34.1 years.

During the previous 24 months, 1/5 participants experienced genital psoriasis, whilst nearly half experienced psoriasis in any other areas of sexual interest. Genital psoriasis and psoriasis at any ASI had a remarkable impact on sexual function: A majority of participants with genital psoriasis suffered from sexual impairment in the last 30 days and this led to 12.8% of participants avoiding sex altogether, and 40.7% of participants avoiding sex during the last week (see Figure). Despite its high impact, only a quarter of these participants discussed having sexual impairments with their dermatologists.

Figure: Proportion of genital psoriasis patients avoiding sexual activities within the past week [5]

Dr Klein and her team concluded that dermatologists should be aware of the high prevalence of genital psoriasis. Therefore, genital areas shouldn’t be neglected when examining patients as psoriasis in this location impairs quality-of-life and often leads to sexual dysfunction.

  1. Da Silva N, et al. Eur J Dermatol 2020;30:267‒78.
  2. Da Silva N, et al. J Eur Acad Dermatol Venereol 2020;34:1010‒1018.
  3. Da Silva N, et al. PLos Online 2020;15:e0235091.
  4. Augustin M, et al. Br J Dermatol 2019;181:358‒65.
  5. Klein TM, et al. Epidemiological Survey on the Prevalence of Genital Psoriasis and Its Impact on Patients’ Sexual Life in Routine Care. P1564, EADV Congress 2022, Milan, Italy, 7–10 September.

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