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Genital Involvement in Psoriasis: Common and Burdensome

Genital psoriasis is associated with significant impairment in quality of life and sexual functioning. Ryan C, Sadlier M, De Vol E, Patel M, Lloyd AA, Day A, Lally A, Kirby B, Menter A. J Am Acad Dermatol. 2015 Jun;72(6):978-83. doi: 10.1016/j.jaad.2015.02.1127. Epub 2015 Mar 29.



  • Psoriasis is a chronic inflammatory which affects 1 to 3% of the population in North America and Europe.
  • It has a significant impact on the quality of life, and even an almost complete clearance with treatment can be unsatisfactory especially when it is located in visible areas such as the face and neck.
  • That being said, normally non-visible involvement in the genital area is associated with a significant impairment in quality of life and sexual functioning.


  • In this prospective study by Menter and colleagues (Dallas-US and Ireland), 354 consecutive patients with psoriasis were evaluated. Genital involvement was measured and evaaluation was done through questionnaires.


  • Results show that almost 40% (n=138) had current genital involvement and almost two-thirds (n=224) had a history of previous involvement.
    • The genital lesions were quite often itchy (87%) and painful (39%)
    • There was interference in sexual functioning:
      • painful intercourse 42%
      • worsening of psoriasis after intercourse 32%
      • decreased subsequent intercourse 43%
    • Questionanaires were significantly worsened in psoriasis patients where genital involvement was present:
      • DLQI (Dermatology Life Quality Index)DLQI, Depression scale, Relationship and Sexuality scales



The typical affected patient is a young male with associated scalp, flexures and overall severe psoriasis.
There is however no association with circumcision or excess weight (obesity)
Genital Psoriasis has a significant negative impact on sexual functioning, with the imaginable consequences on psychological well-being.
Therefore dermatologists should examine patients completely, looking for presence of genital disease and measure its impact on the quality of life