Sexual dysfunction in patients with psoriasis and psoriatic arthritis--a systematic review

Psoriasis is a cutaneous-articular disease, whose incidence ranges from 1% to 3%. Stress tends to be a triggering or aggravating factor in psoriasis. In addition, the disease itself can generate emotional stress because of its lesions. Several psychological disorders can be associated with psoriasis, and feelings such as rage, depression, shame, and anxiety have been commonly reported, which can culminate in social isolation and sexual dysfunction. Despite being a common complaint among patients with psoriasis, sexual dysfunction has been rarely reported in the literature. This study aimed at performing a systematic review of the prevalence of sexual dysfunction in psoriasis and psoriatic arthritis, assessing the role played by factors such as depression and severity of disease in this relation. This systematic review showed that data on the sexual difficulties of patients with psoriasis are scarce. The hypotheses to explain sexual dysfunction in that group of patients include the severity of skin findings, the psychological effects of the condition on the patient, concerns of the sexual partner, and side effects of the medical treatments for psoriasis. Those data emphasize that this type of symptomatology is frequently neglected in medical practice, and stress the importance of assessing the impact of psoriasis regarding not only cutaneous and joint involvements, but also psychosocial and sexual impairments. Considering the sociocultural diversities of each population, a specific study of the Brazilian population to provide more information about our patients is required.