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Genital Psoriasis and Patient-reported Burden: Sexual Function, Genital Self-image, and Quality of Life

Year: 2026
Type: article
Abstract: Genital psoriasis is a common but frequently underrecognized manifestation of psoriatic disease whose burden is poorly represented by conventional measures based on body surface area or overall plaque severity. Local symptoms, including pruritus, burning, pain, fissuring, and postcoital exacerbation, may impair physical comfort, sexual activity, intimate relationships, genital self-image, and psychological well-being. Patients commonly report embarrassment, fear of rejection, avoidance of sexual contact, reduced sexual desire, and concern that genital lesions may be mistaken for a sexually transmitted infection. However, the relationship between genital psoriasis and physiological sexual dysfunction is complex and influenced by age, cardiovascular risk, depression, anxiety, psoriatic arthritis, relationship factors, and psoriasis affecting other sexually sensitive body regions. Generic instruments such as the Dermatology Life Quality Index, Female Sexual Function Index, and International Index of Erectile Function provide useful information but incompletely capture genital-specific symptoms and avoidance behaviors. Genital-specific measures, including the Genital Psoriasis Symptoms Scale and Genital Psoriasis Sexual Frequency Questionnaire, offer greater content validity but require broader independent evaluation. Clinical trials and real-world studies indicate that effective topical, oral, and biologic therapy may improve genital symptoms, quality of life, and sexual activity. Nevertheless, sexual and relationship-related impairment may persist despite cutaneous improvement. This review synthesizes current evidence on the patient-reported burden of genital psoriasis, identifies limitations of available outcome measures, and proposes a patient-centered framework for clinical assessment and therapeutic decision-making.
Language: English
Subfield: Immunology
Open Access status: gold
Estimated APC paid: $100
OpenAlex ID: W7204159029
FWCI:
Cites: 30
Cited by:
Related to: 10