Evaluation of factors associated with sexual dysfunction in psoriasis in a cohort of 1409 patients

Abstract

MCS has a large impact on patients' mental wellbeing and their ability to carry out activities of daily living, because of the 'hidden dangers' of environmental chemical exposure. This impact is further heightened by patients feeling that their condition is not recognized by others, leading to a 'profound sense of invisibility'. 2 The prevalence of physician-diagnosed MCS has been found to be 0.5%. 3 No objective proof of a causal relationship between chemical exposure and symptoms has been shown, and the pathophysiology remains unclear, 4 although there appears to be overlap with other somatoform syndromes, such as fibromyalgia. Many different chemicals are implicated, including insecticides, disinfectants, perfumes, weed-killers, bleach, exhaust fumes and paints.Owing to its subjective nature, an unequivocal diagnosis of MCS is challenging. Diagnostic criteria have been proposed 5 to help diagnose MCS (Table 1).Clearly, avoiding multiple environmental substances is not possible or practical. Therefore, management focuses on coping techniques, support, and treating any associated psychological distress or psychiatric illness.This case highlights a poorly understood condition and the impact of the COVID-19 pandemic.

Sexual dysfunctions in psoriatic patients

“…However, our study showed more abnormalities in subjects undergoing systemic treatment, it should be emphasized that the topical therapy can also be troublesome due to the consistency and fragrance of the topical agents ( 19 ). We must also highlight that, unfortunately, we were not able to assess the severity or resolution of lesions after the treatment.…”

“…Topical and systemic antipsoriatic treatment is considered to be another cause of sexual dysfunctions ( 12 , 19 ). For example, methotrexate can lead to erectile dysfunction and reduced libido ( 20 , 21 ).…”

“…Reduced total testosterone and increased estradiol in the blood are also reported in male patients (18). Topical and systemic antipsoriatic treatment is considered to be another cause of sexual dysfunctions (12,19). For example, methotrexate can lead to erectile dysfunction and reduced libido (20,21).…”