Background: Psoriasis in the genital area is often neglected, although it bothers a substantial number of patients. Objective: To study both the role of the physician in the treatment of genital psoriasis and the symptom intensity of these lesions as experienced by the patients. Methods: A detailed self-administered questionnaire (containing items on the role of the physician and genital symptom intensity, range 0–10) was filled in by members of the Dutch Psoriasis Society. Results: Data of 277 patients with genital psoriasis were analyzed. A total of 45.8% did not discuss the presence of genital psoriasis with their physician, 25% believed that the physician paid sufficient attention to genital lesions, and 67.8% never applied treatment for genital lesions. Mean symptom intensity ranged from 2.4 to 5.1, all scores being significantly higher for women compared to men. Severe symptoms were present in up to 43.5% of patients. Of these patients, up to 38.1% did not discuss the symptoms with their physician. Conclusion: The consultation rate for genital lesions is low, while numerous patients report a significant burden of disease.

1.
Farber EM, Bright RD, Nall ML: Psoriasis. A questionnaire survey of 2,144 patients. Arch Dermatol 1968;98:248–259.
2.
Farber EM, Nall ML: The natural history of psoriasis in 5,600 patients. Dermatologica 1974;148:1–18.
3.
Hellgren L: Psoriasis. A statistical, clinical and laboratory investigation of 255 psoriatics and matched healthy controls. Acta Derm Venereol 1964;44:191–207.
4.
Meeuwis KA, de Hullu JA, de Jager ME, et al: Genital psoriasis: a questionnaire-based survey on a concealed skin disease in the Netherlands. J Eur Acad Dermatol Venereol 2010;24:1425–1430.
5.
Bachmann G: Female sexuality and sexual dysfunction: are we stuck on the learning curve? J Sex Med 2006;3:639–645.
6.
Wendt E, Hildingh C, Lidell E, et al: Young women’s sexual health and their views on dialogue with health professionals. Acta Obstet Gynecol Scand 2007;86:590–595.
7.
Niemeier V, Winckelsesser T, Gieler U: Skin disease and sexuality. An empirical study of sex behavior of patients with psoriasis vulgaris and neurodermatitis in comparison with skin-healthy probands (in German). Hautarzt 1997;48:629–633.
8.
Meeuwis KA, de Hullu JA, van de Nieuwenhof HP, et al: Quality of life and sexual health in patients with genital psoriasis. Br J Dermatol 2011;164:1247–1255.
9.
Dodd M, Janson S, Facione N, et al: Advancing the science of symptom management. J Adv Nurs 2001;33:668–676.
10.
Ljosaa TM, Rustoen T, Mork C, et al: Skin pain and discomfort in psoriasis: an exploratory study of symptom prevalence and characteristics. Acta Derm Venereol 2010;90:39–45.
11.
Sampogna F, Gisondi P, Melchi CF, et al: Prevalence of symptoms experienced by patients with different clinical types of psoriasis. Br J Dermatol 2004;151:594–599.
12.
Goldman BD: Common dermatoses of the male genitalia. Recognition of differences in genital rashes and lesions is essential and attainable. Postgrad Med 2000;108:89–91, 95–96.
13.
Pincus SH: Vulvar dermatoses and pruritus vulvae. Dermatol Clin 1992;10:297–308.
14.
Porter WM, Bunker CB: The dysfunctional foreskin. Int J STD AIDS 2001;12:216–220.
15.
van Dijk F, Thio HB, Neumann HAM: Non-oncological and non-infectious diseases of the penis (penile lesions). EAU-EBU Update Series 2006;4:13–19.
16.
Zamirska A, Reich A, Berny-Moreno J, et al: Vulvar pruritus and burning sensation in women with psoriasis. Acta Derm Venereol 2008;88:132–135.
17.
van de Kerkhof PCM: Clinical features; in van de Kerkhof PCM (ed): Textbook of Psoriasis, ed 2. Oxford, Blackwell Publishing, 2003, pp 3–29.
18.
Feldman SR, Fleischer AB Jr, Reboussin DM, et al: The self-administered psoriasis area and severity index is valid and reliable. J Invest Dermatol 1996;106:183–186.
19.
Meeuwis KA, de Hullu JA, Massuger LF, et al: Genital psoriasis: a systematic literature review on this hidden skin disease. Acta Derm Venereol 2011;91:5–11.
20.
Schwegler J, Schwarz J, Eulenburg C, et al: Health-related quality of life and patient-defined benefit of clobetasol 0.05% in women with chronic lichen sclerosus of the vulva. Dermatology 2011;223:152–160.
21.
van de Nieuwenhof HP, Meeuwis KA, Nieboer TE, et al: The effect of vulvar lichen sclerosus on quality of life and sexual functioning. J Psychosom Obstet Gynaecol 2010;31:279–284.
22.
Sampogna F, Tabolli S, Soderfeldt B, et al: Measuring quality of life of patients with different clinical types of psoriasis using the SF-36. Br J Dermatol 2006;154:844–849.
23.
Dawson A, List T: Comparison of pain thresholds and pain tolerance levels between Middle Easterners and Swedes and between genders. J Oral Rehabil 2009;36:271–278.
24.
Sheffield D, Biles PL, Orom H, et al: Race and sex differences in cutaneous pain perception. Psychosom Med 2000;62:517–523.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.