Sexual Dysfunction in Women and Men with Psoriasis: A Cross-Sectional Questionnaire-Based Study

Abstract

Background and objectives: Psoriasis can lead to feelings of stigmatization, hinder social functioning, and impair quality of life. Psoriasis can also affect sexual activity, but there is still little research on this topic. The present study investigated whether and to what extent psoriasis, its severity, location and extent of skin lesions affect sexual dysfunction. Materials and Methods: A total of 45 women and 64 men aged 18 to 73 years hospitalized for psoriasis exacerbations were included in the study. Psoriasis severity, as assessed by the Psoriasis Area and Severity Index (PASI), ranged from 0.2 to 65 points (mean: 17.0 ± 14.9 points). After collecting demographic and clinical data, each subject was asked to complete the Dermatology Life Quality Index, the 11-item Sexual Life Questionnaire and the International Index of Erectile Function (only men). Results: Our study found that more than 90% of the patients surveyed felt at least a slight unattractiveness due to psoriasis. In approximately 80% of the subjects, the skin lesions at least occasionally affected their sex life, and more than 50% at least sometimes avoided sexual contact. The location of psoriasis, particularly in the genital area (p = 0.01), on the face (p = 0.03) and hands (p = 0.05), also had a significant impact on the level of sexual problems. Psoriasis has a significant impact on the quality of life (QoL), and a deterioration in QoL was strongly correlated with sexual dysfunction (r = 0.6, p < 0.001), PASI scores (r = 0.36, p < 0.001), self-assessment of psoriasis severity and location of psoriatic lesions. Conclusions: Psoriasis leads to various limitations, especially in the sphere of sexual life. Patients with psoriasis feel stigmatized, have lowered self-esteem and consequently experience significant sexual problems. Awareness of the co-occurring psychological aspect of psoriasis and the routine use of validated scales in dermatology practice should contribute to the rapid identification of patients with sexual dysfunction.

Sexual dysfunctions in psoriatic patients

“…No correlation between erectile dysfunction and the presence of such lesions was also found by Wojciechowska-Zdrojowy or Cabete et al In our study, almost half of the patients had lesions in the anogenital area but there was no correlation with FSFI or IIEF scores. Opposite results were reported by Kędra et al who observed that the severity of sexual problems was associated with the lesions in the genital area, but also on the face or hands, not with the IIEF-5 (5-question version of IIEF) score ( 39 ).…”

“…In our study, we did not assess psoriasis activity and severity index (PASI) since it was an online survey however in other experiments the results are diversified. In the paper by Kędra et al there was a correlation between sexual problems and PASI in both sexes ( 39 ) and in the paper by Wojciechowska-Zdrojowy et al – in men ( 27 ). Kwan et al assessed only body surface area (BSA) affected with lesions and found a significant difference in sexual function between patients with BSA more or less than 10 ( 36 ).…”

“…In our study, we did not assess psoriasis activity and severity index (PASI) since it was an online survey however in other experiments the results are diversified. In the paper by Kędra et al there was a correlation between sexual problems and PASI in both sexes (39) (38), whereas the other one found higher PASI among female patients with significantly decreased FSFI score (33,38). In the study by Al Mazeedi and Türel et al, no significant difference was observed between patients with mild or severe psoriasis in terms of the quality of their sexual life (31, 40).…”

Psycho-Social Impact and Quality of Life Among Patients With Psoriasis Attending a Tertiary Care Institute in North Chennai

“…Another study by Gupta et al had similar results, which documented that 40.8% of the study participants had reported having their sexual lives impacted by psoriasis. [12] Kędra et al also reported that approximately 80% had an affected sexual life due to the skin lesions, and more than 50% at least sometimes avoided sexual contact [13].…”

Speed and Cumulative Responses According to Body Regions in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Ixekizumab (Interleukin-17A Antagonist) versus Guselkumab (Interleukin-23p19 Inhibitor)

“…For instance, the head and the upper extremities are visible body regions and, therefore, their involvement has been reported to be associated with higher feelings of stigmatization and levels of social anxiety [ 18 ]. The trunk includes the genitals, and genital involvement has been shown to impact patients’ intimate relationships [ 19 ].…”