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Psoriasis could increase the risk of sexual dysfunction, particularly in patients with psychological comorbidity, shows a study published in JAMA Dermatology.
“Patients with psoriasis have physical and psychological comorbidities that have been associated with a higher risk of sexual dysfunction. In addition, psoriasis may play a role in its development. The presence of anxiety, depression, psoriatic arthritis, genital lesions, and increasing age should raise the awareness of sexual dysfunction,” wrote researchers who were led by Alejandro Molina-Leyva, M.D., Ph.D., of the Hospital Universitario Virgen de las Nieves in Granada, Spain.
The systematic review included 28 studies, 52,520 cases of psoriasis and 1,806,022 controls. The 28 studies included 19 cross-sectional studies, three clinical trials, three quasi-experimental studies, two population-based cohort studies, and one population-based case-control study.
The prevalence of sexual dysfunction ranged from 40-55.6 percent and erectile dysfunction ranged from 34.2-81.1 percent. Two studies observed an association between psoriasis and sexual dysfunction after adjusting for physical and psychological comorbidities. Five of eight studies observed an independent association between erectile dysfunction and psoriasis.
Among patients with psoriasis, the features that showed the strongest association with sexual dysfunction were anxiety and depression (five of five studies), psoriatic arthritis (three of four studies), and genital psoriasis (five of seven studies). Anxiety, depression, and increasing age showed the strongest association with erectile dysfunction.
All three clinical trials using biologic drugs showed an improvement in sexual dysfunction compared with placebo.
Molina-Leyva A, et al. Association Between Psoriasis and Sexual and Erectile Dysfunction in Epidemiologic Studies: A Systematic Review. JAMA Dermatol. Published online October 10, 2018. doi:10.1001/jamadermatol.2018.3442