Psoriasis and sex: a study of moderately to severely affected patients

Psoriasis can have a significant impact upon sexual functioning for 30%-70% of patients. We examined the dermatologic and psychologic factors associated with the effect of psoriasis on this important dimension of quality of life.

One hundred and twenty consenting psoriasis patients (63 men and 57 women; mean +/- SD age, 46.8 +/- 15.7 years; mean +/- SD total body surface area affected, 53.4% +/- 22.9%) completed a battery of questionnaires which included their response (endorsed with a "Yes" or "No") to the following question: "Do you believe that since the onset of psoriasis your sexual activity has declined?" The differences in dermatologic and psychologic measures between the subgroup that endorsed a "Yes" response and the subgroup that endorsed a "No" response were examined.

Forty-nine out of 120 patients (40.8%) were sexually affected, i.e. they endorsed a "Yes." There were no significant differences between the affected and unaffected groups with respect to marital status, age, sex, and duration of psoriasis. The affected group reported more joint pains (P = 0.01), marginally greater psoriasis severity affecting the groin region (P = 0.07), greater scaling (P = 0.06), and greater pruritus severity (P = 0.07). Psychologically, the affected group had higher depression scores (P = 0.02) which were in the range for clinical depression, a greater tendency (P = 0.02) to seek the approval of others, and a marginally greater tendency (P = 0.08) to drink alcohol. A decline in sexual activity was related to a decrease in the patient's sex drive for 42.6% of patients; however, only 14.9% of these patients attributed the decline in their sexual activity to decreased sex drive of their spouse/partner.

In addition to some dermatologic factors, comorbid psychologic factors, such as depression and a tendency for alcohol use, may be important determinants of decreased sexual functioning in psoriasis.