Adult Vulval Psoriasis: Clinical Presentation, Management and Impact on Quality of Life

To explore the clinical presentation, management and impact on quality of life in women with vulval psoriasis.

A retrospective, single-centre cohort study of women was conducted at a large dermatology practice from January 2016 to January 2024. Sequential Vulval Quality of Life Index scores and patient data were systematically collected and recorded in an online patient database. Treatment regimens were individualised and titrated to clinical response.

The study included a total of 350 patients with vulval psoriasis over an eight-year period. 13.1% of patients required systemic treatment solely for vulval disease. The median VQLI score improved from 18.0 ± 9.4 at baseline to 9.7 ± 7.6 at the end of follow-up (p < 0.0001). All domains showed statistically significant improvements except for 'Sexual Function'. The domains with the greatest improvement were 'Future Health Concerns' (69.2%, p < 0.001), 'Feelings and Emotions' (63.4%, p < 0.001) 'Symptoms' (58.6%, p < 0.001) and 'Activities of Daily Living' (56.8%, p < 0.001).

Vulval psoriasis has a substantial impact on quality of life but remains underdiagnosed and undertreated. While treatment can significantly improve outcomes, issues related to sexual function and relationships often persist. Systemic therapy may be required for a subset of patients with vulval-only disease. Routine assessment and targeted management of vulval involvement are crucial to optimising patient well-being.