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Genital psoriasis affects over one-fifth of patients and leads to substantial sexual impairment, with up to 60% reporting difficulties and over 40% avoiding intimacy despite widespread systemic treatment.
Psoriatic disease affecting the genital region (GenPsO) and other areas of sexual interest (ASI) remains a clinically sensitive yet underrecognized burden, frequently diminishing quality of life (QoL) and disrupting intimate well-being. A nested cohort study conducted in Germany examined the real-world prevalence and impact of genital psoriasis and psoriatic involvement of sexually sensitive sites in routine clinical practice.
Adult patients enrolled in the German PsoBest registry were surveyed by a structured postal questionnaire to capture real-world data on genital and sexually sensitive psoriasis involvement. The primary endpoints were the 12-month and 24-month prevalence of and psoriasis affecting any ASI, including the anal region, gluteal area, groin, lower back, and chest/breast. To quantify symptom burden and sexual impact, investigators administered validated tools: the reasons for sexual impairment (RSI) questionnaire, the genital psoriasis symptoms scale (GPSS), and the genital psoriasis sexual impact scale. Demographic information and detailed disease characteristics were systematically collected and analyzed.
Of 2,010 patients contacted, 811 (40.3%) returned the survey, and 795 (39.6%) complete responses were included in the final analysis (Table 1). Psoriasis affecting the genital and other sensitive body areas typically began in the mid-adult years. In routine care, involvement of these regions was relatively common, with a notable proportion of patients experiencing active disease at the time of assessment. Despite widespread use of systemic treatments, the disease burden remained considerable. Importantly, psoriasis in these areas had a substantial negative impact on patients’ sexual life, with many reporting recent impairment, particularly those with genital involvement (Table 1).
The mean GPSS score was 27.6 ± 18.6, indicating notable symptom severity. Furthermore, among those with genital involvement, 40.7% (n=35) reported always avoiding sexual activity during the past week. Reported drivers of sexual dysfunction included psychological stress, reduced self-confidence, and psoriasis-related pain or movement restriction, highlighting both the physical and emotional dimensions of disease burden.
The findings of this epidemiologic survey underscore that psoriasis in genital and sensitive areas is both common and under-addressed in routine care, despite widespread usage of systemic treatments. Regular examination of the genital and ASI regions during clinical visits is fundamental to ensure early detection and appropriate management. Improving recognition and treatment of genital psoriasis could help minimize sexual avoidance, enhance quality of life, and limit long-term psychosocial burden in the affected patients.
Psoriasis: Targets and Therapy
Prevalence of Genital Psoriasis and Its Impact on Patients’ Sexual Life in Routine Care: Epidemiologic Survey in Germany
Toni Maria Janke et al.
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