Psoriasis linked to sexual dysfunction
Psoriasis could increase the risk of sexual dysfunction (SD), including erectile dysfunction (ED), particularly in patients with psychological comorbidity, according to a recent systematic review published in JAMA Dermatology (2019;155:98–106).
The review included 28 studies including 52 520 cases of psoriasis and 1 806 022 controls. Two of the studies observed an association between psoriasis and SD after adjusting for physical and psychological comorbidities. Five studies observed an independent association between ED and psoriasis. Among patients with psoriasis, the features that showed the strongest association with SD were anxiety and depression, psoriatic arthritis, and genital psoriasis. Anxiety and depression and increasing age showed the strongest association with ED. All three clinical trials using biologic drugs showed an improvement in SD compared with placebo.
According to the researchers, patients with psoriasis have physical and psychological comorbidities that are associated with a higher risk of SD, and psoriasis may play a role in its development. Clinicians should be aware that anxiety, depression, psoriatic arthritis, genital lesions, and increasing age are risk factors for SD; and effective treatment of psoriasis can improve SD.