Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.