Psychosexual burden in adult genital psoriasis: outcome measurement, construct coverage, and clinical recognition...

Adult genital psoriasis is associated with local symptoms and effects on sexual activity, intimate relationships, body exposure, and patient communication. The associated psychosexual burden is not adequately summarized by lesion severity or sexual function scores alone. This integrative review examines outcome measurement, construct coverage, and clinical recognition of psychosexual burden in adult genital psoriasis. Existing measurement tools and related measurement approaches capture several relevant components, including genital-site severity, local symptoms, sexual activity-related impact, sexual function, quality of life, sexual health-related quality of life, genital self-image, sexual distress, and selected communication or care needs. These tools and approaches differ in measurement targets, assessment perspectives, applicable populations, scoring assumptions, and contexts of use. They therefore do not readily provide a complete representation of psychosexual burden. This review uses four candidate domains-symptom experience, sexual and intimacy-related impact, psychological and self-presentation burden, and communication and care needs-to compare construct coverage across existing tools. Sexual function scores provide information on sexual response and functional status, but do not substitute for identifying sexual distress, sexual avoidance, genital self-image, self-presentation burden, or communication needs. Even when related burden is recorded in research instruments, it does not necessarily gain clinical visibility in routine dermatology practice. To address this clinical recognition gap, this review proposes a brief, non-diagnostic, low-burden communication entry point that serves as a conceptual starting point for initial discussion, documentation, and future evaluation of psychosexual concerns in routine dermatology practice.