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Krajewski PK, Strobel A, Schultheis M, Staubach P, Grabbe S, Hennig K, Matusiak L, von Stebut E, Garcovich S, Bayer H, Heise M, Kirschner U, Nikolakis G, Szepietowski JC. Profound Sexual Dysfunction Among Patients with Hidradenitis Suppurativa: A Cross-sectional Study. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01196-y. [PMID: 38869824 DOI: 10.1007/s13555-024-01196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/24/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Sexual health, a critical aspect of overall well-being, is often compromised in individuals with chronic disorders. Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that mainly affects intertriginous areas, potentially impacting sexual health as a result of its specific symptoms and psychosocial burden. METHODS This cross-sectional study utilized data from the EpiCAi project, focusing on 199 patients with HS. Participants completed digital questionnaires assessing sexual health via sex-specific instruments: the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men, alongside different psychosocial scales. The disease severity was assessed using the Hurley stage and the Lesion Identification Scheme for Acne Inversa (LISAI). RESULTS The majority of the participants reported impaired sexual health, with significant clinical sexual dysfunctions noted in 71.8% of women (FSFI score < 26) and erectile dysfunction in 63.8% of men. Sexual dysfunction was associated with several factors, including age, and marital status. Psychosocial factors, notably depression and quality of life, showed strong correlations with sexual health outcomes. Notably, women over 40 and those treated with biologics reported more severe dysfunction, while among men, employment status significantly influenced sexual health. CONCLUSIONS HS profoundly affects the sexual health of both male and female patients, with significant impacts on their quality of life and psychological well-being. The findings underscore the necessity for healthcare providers to address sexual health proactively in the management of HS, considering both physical symptoms and psychosocial impacts. This holistic approach is essential for improving patient outcomes and overall quality of life. TRIAL REGISTRATION German Register for Clinical Trials, identifier DRKS00025315.
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Affiliation(s)
- Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland
| | - Alexandra Strobel
- Faculty of Medicine, Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Profile Centre of Health Sciences Halle, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | - Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Katharina Hennig
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Hans Bayer
- Dermatology Outpatient Office Hautmedizin Bad Soden, Bad Soden, Germany
| | - Marcus Heise
- Faculty of Medicine, Profile Centre of Health Sciences Halle, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Institute for Health- and Nursing Science, Martin-Luther-University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland.
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Shah SFH, Merchant SA, Shah SA. Female sexual dysfunction in psoriasis: a systematic review and meta-analysis using the Female Sexual Function Index. Int J Impot Res 2024; 36:232-241. [PMID: 36456639 DOI: 10.1038/s41443-022-00650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
Psoriasis is an inflammatory skin condition that can negatively affect numerous domains for quality of life, including sexual function. We aimed to systematically compare sexual function between women with and without psoriasis through meta-analysis. Databases were searched for studies assessing sexual function in women with and without psoriasis using the Female Sexual Function Index (FSFI). Meta-analyses were conducted in R (v4.1.2) to determine: (i) the odds ratio (OR) of sexual dysfunction and (ii) the mean difference (MD) for FSFI scores and sub-scores. Eight studies (five case-control, three cross-sectional) were eligible for review, encompassing 563 women with psoriasis and 525 controls. Risk of bias for included studies was considered as low to moderate. Psoriasis was associated with greater odds of female sexual dysfunction (OR 2.67, 95% CI 1.93,3.69; p < 0.0001). Compared to controls, women with psoriasis had significantly lower mean scores for desire (p < 0.0001), arousal (p = 0.002), lubrication (p = 0.003), orgasm (p < 0.0001), satisfaction (p < 0.0001) and total scores (p < 0.0001). Mean pain scores did not significantly differ between psoriasis patients and controls (p = 0.051). We identified significantly impaired sexual function in women with psoriasis compared to controls, suggesting that routine assessment of sexual health may be beneficial. Prospective studies of larger sample size are required in order to explore the underlying mechanisms and risk factors.
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Nowowiejska J, Karny A, Nesterowicz M, Purpurowicz P, Baran A, Kaminski TW, Purpurowicz Z, Flisiak I. Sexual dysfunctions in psoriatic patients. Front Public Health 2024; 12:1339196. [PMID: 38694987 PMCID: PMC11061483 DOI: 10.3389/fpubh.2024.1339196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/21/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Psoriasis is one the most common skin diseases associated with a great decrease in the quality of patients' lives. Methods We aimed to study sexual dysfunctions in psoriatic patients using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men via an anonymous online survey. The study included 80 psoriatic patients and 75 controls without dermatoses. Results There was a downward trend in the total IIEF score in psoriatic men compared to controls. 58% of male patients and 76% of controls had a normal IIEF score. There was no significant difference in IIEF between patients treated and not with systemic agents. 62% of female patients had a decreased FSFI score, whereas in the control group, the majority of subjects (54%) had a normal FSFI score. There was no significant difference in FSFI score between patients and controls. Female patients treated with systemic antipsoriatic agents had significantly worse lubrication, satisfaction with sexual life, and pain. Discussion Our study has shown that the majority of questioned female psoriatic patients had sexual dysfunction according to FSFI, particularly they had worse satisfaction with sexual life and less sexual desire compared to women without psoriasis. The majority of male patients did not have sexual dysfunction according to IIEF, however, they had significantly worse overall satisfaction with sexual life and confidence to keep an erection. Systemic antipsoriatic treatment does not probably influence sexual dysfunctions in men but it does in women although we were not able to assess the severity or resolution of lesions after those treatments. However embarrassing, psoriatic patients should be questioned about their sexual lives by dermatologists, and more studies are needed to explore this matter.
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Affiliation(s)
- Julia Nowowiejska
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Agata Karny
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Miłosz Nesterowicz
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Piotr Purpurowicz
- Department of Urology and Urological Oncology, Municipal Polyclinical Hospital, Olsztyn, Poland
| | - Anna Baran
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Tomasz W. Kaminski
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zbigniew Purpurowicz
- Department of Urology and Urological Oncology, Municipal Polyclinical Hospital, Olsztyn, Poland
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
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Iocca F, Burlando M, Angelo NL, Ragucci F, Pugi D, Parodi A, Dèttore D, Pozza A. Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:439-455. [PMID: 38288968 DOI: 10.1080/0092623x.2024.2302959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.
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Affiliation(s)
- Francesco Iocca
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Nicole Loren Angelo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Federica Ragucci
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Daniele Pugi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Aurora Parodi
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Andrea Pozza
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Psychology Unit, Department of Mental Health, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Calvo Moya M, Mesonero Gismero F, Suarez Ferrer C, Hernández-Camba A, Vásquez Carlón D, García Benasach F, Aguas Peris M, Delgado Oliva FJ, González-Lama Y, Millán Scheiding M, Alonso Sebastián I, Camacho Martel L, Gallardo Arriero V, Echarri Piudo A, Bella Castillo P, Cano Sanz N, Vera Mendoza MI, Serrano Labajos R, Valdivia Martínez A, Pérez Restoy L, Zabana Abdo Y, Mañosa Ciria M, Rodríguez-Moranta F, Barreiro-de Acosta M, Gutiérrez Casbas A. Position statement of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis on sexuality and inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2024:S0210-5705(24)00019-0. [PMID: 38218430 DOI: 10.1016/j.gastrohep.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
It is widely acknowledged that inflammatory bowel disease (IBD) is associated with a high prevalence of sexual dysfunction (SD). However, there is a notable paucity of specific literature in this field. This lack of information impacts various aspects, including the understanding and comprehensive care of SD in the context of IBD. Furthermore, patients themselves express a lack of necessary attention in this area within the treatment of their disease, thus creating an unmet need in terms of their well-being. The aim of this position statement by the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) is to provide a review on the most relevant aspects and potential areas of improvement in the detection, assessment, and management of SD in patients with IBD and to integrate the approach to sexual health into our clinical practice. Recommendations are established based on available scientific evidence and expert opinion. The development of these recommendations by GETECCU has been carried out through a collaborative multidisciplinary approach involving gastroenterologists, gynecologists, urologists, surgeons, nurses, psychologists, sexologists, and, of course, patients with IBD.
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Affiliation(s)
- Marta Calvo Moya
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
| | - Francisco Mesonero Gismero
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España
| | - Cristina Suarez Ferrer
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación Hospital Universitario La Paz, Madrid, España
| | - Alejandro Hernández-Camba
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| | - Danízar Vásquez Carlón
- Centro de Asistencia a la Reproducción Humana de Canarias (FIVAP), San Cristóbal de la Laguna, Tenerife, España
| | - Fátima García Benasach
- Servicio de Ginecología y Obstetricia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mariam Aguas Peris
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitari i Politécnic La Fe, Valencia, España
| | | | - Yago González-Lama
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mónica Millán Scheiding
- Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari i Politécnic La Fe, Valencia, España
| | - Isabel Alonso Sebastián
- Unidad de Coloproctología, Servicio de Cirugía general y Aparato Digestivo. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Laura Camacho Martel
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Virgen de la Victoria, Málaga, España
| | - Vanesa Gallardo Arriero
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ana Echarri Piudo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - Pablo Bella Castillo
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Noelia Cano Sanz
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario de León, León, España
| | - María Isabel Vera Mendoza
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ruth Serrano Labajos
- Confederación Asociaciones de enfermos de Crohn y Colitis Ulcerosa de España, Madrid, España
| | | | - Lourdes Pérez Restoy
- Sexología, Clínica Bonadea, Granada, España; Neurohábilis Centro de Salud Integral, Granada, Loja y Puerto de Santa María, España
| | - Yamile Zabana Abdo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitari Mútua de Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España
| | - Miriam Mañosa Ciria
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Hospital Universitari Germans Trias i Pujol Badalona, Barcelona, España
| | - Francisco Rodríguez-Moranta
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Manuel Barreiro-de Acosta
- Unidad de Enfermedad Inflamatoria Intestinal, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, España
| | - Ana Gutiérrez Casbas
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital General Universitario Dr. Balmis de Alicante, ISABIAL, Alicante, España
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Gonzalez-Cantero A, Constantin MM, Dattola A, Hillary T, Kleyn E, Magnolo N. Gender perspective in psoriasis: a scoping review and proposal of strategies for improved clinical practice by European dermatologists. Int J Womens Dermatol 2023; 9:e112. [PMID: 37915402 PMCID: PMC10615520 DOI: 10.1097/jw9.0000000000000112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/26/2023] [Indexed: 11/03/2023] Open
Abstract
Background The prevalence of psoriasis is similar between men and women; however, evidence exists of sex- and gender-related differences in disease expression, impact, coping, and needs of patients with psoriasis. These differences are essential and should be considered in clinical practice and research. Objective To compile available evidence on sex- and gender-related differences in psoriasis, identify the most critical gaps in clinical practice and research, and use it to propose strategies for improved clinical practice. Methods Six European dermatologists selected the topics to consider according to their relevance in the dermatology setting with the support of methodologists. Evidence on sex- and gender-related differences was obtained by a scoping review based on search strategies in Medline and Cochrane Library from inception to October 2021 using the following terms: arthritis, psoriatic, psoriasis, gender, and sex. The panel discussed the results and proposed strategies by consensus. Results The scoping review identified broad themes: (1) clinical expression, (2) severity and patient-reported outcomes, (3) psychosocial impact, (4) access to treatments and propensity to treat, (5) comorbidities, and (6) treatment effect. The strategies are based on these broad themes. Limitations No risk of bias assessment was done due to the scoping nature of the review. Conclusion This review offers insights into gender differences in psoriasis, providing a foundation for improving clinical practice and patient outcomes.
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Affiliation(s)
- Alvaro Gonzalez-Cantero
- Department of Dermatology, Hospital Universitario Ramon y Cajal, Madrid, Spain
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - María Magdalena Constantin
- Departments of Dermatologists, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Annunziata Dattola
- Department of Dermatology, University of Rome “Tor Vergata,” Rome, Italy
| | - Tom Hillary
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Elise Kleyn
- Brain-Skin Unit, The Dermatology Centre, Departments of Dermatologists, University of Manchester and Salford Royal Hospital, Manchester, UK
| | - Nina Magnolo
- Department of Dermatology, University Hospital of Muenster, Muenster, Germany
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Kędra K, Reich A. Skin-Related Sexual Life Questionnaire (SRSLQ): Creation and Validation of the Questionnaire. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2023. [PMID: 38004072 PMCID: PMC10673023 DOI: 10.3390/medicina59112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/08/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The assessment of sexual dysfunction among psoriatic patients still remains a great diagnostic difficulty due to its subjective and embarrassing character. Various questionnaires have been used to assess sexual dysfunctions associated with skin conditions; however, none of them have been approved as a gold standard. The aim of our study was to create and validate the Skin-Related Sexual Life Questionnaire (SRSLQ) for the assessment of possible sexual dysfunction and related psychological burdens in patients with skin diseases. Materials and Methods: A total of 109 patients, including 45 women and 64 men (1:1.4) suffering from psoriasis and aged between 18 and 73 years (mean 48.0 ± 13.4 years), were included in the study. All subjects completed the 11-item SRSLQ and the Dermatology Life Quality Index (DLQI). In addition, all men were asked to fulfil the five-item version of the International Index of Erectile Dysfunction (IIEF-5) at the time of examination and 7 days after enrollment. The disease severity was assessed via the PASI scale. Results: The statistical analysis of internal consistency of SRSLQ showed very good integrity, with a Cronbach α coefficient of 0.94. The reproducibility level assessed with intraclass correlation coefficient (ICC) amounted to 0.96. A significant correlation between the total score of the 11-item SRSDQ and the DLQI (r = 0.39; p < 0.001) was found, confirming congruent validity. Conclusions: The validated 11-item Skin-Related Sexual Life Questionnaire can be successfully implemented in daily clinical practice as well as in clinical research.
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Affiliation(s)
- Kamila Kędra
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland;
- Doctoral School, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland;
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Elsaie ML, Hanafy NS, Hussein SM, Abou Zeid OO, Zaky MS, Eldahshan RM, Nada HA, Sayedahmed O, El Zawahry YB. Prevalence of Female Sexual Dysfunction Among Psoriatic Females: A Cross Sectional Case Controlled Study. Dermatol Pract Concept 2023; 13:e2023209. [PMID: 37557143 PMCID: PMC10412072 DOI: 10.5826/dpc.1303a209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Sexual relationships are an integral part of females psychological and physiological wellbeing. OBJECTIVES The study aimed to identify prevalence and impact of Female Sexual Dysfunction (FSD) in women affected with psoriasis. METHODS This cross-sectional study was carried out on 150 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 100 female patients complaining of psoriasis (50 suffering from moderate psoriasis and 50 with severe psoriasis). The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) while the second group included 50 age matched women who served as controls. RESULTS Female sexual dysfunction (FSD) in psoriasis female groups was higher than that in the control group (47%, 24%, P < 0.05). The mean total scores of FSFI ranged from 12.30 to 34.20 and were significantly lower in the severe PASI affected group (22.34 ± 5.35) when compared to moderate PASI group (26.24 ± 2.67) or control group (28.79 ± 2.22). In addition, total scores were significantly lower among moderate PASI affected females when compared to control group. CONCLUSIONS Sexual dysfunction should be routinely investigated in female patients with psoriasis in the case of moderate-severe disease due to its negative impact on quality of life. Further research over the effect of certain interventional programs on FSD should be considered for patients suffering from psoriasis.
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Affiliation(s)
- Mohamed L. Elsaie
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Noha S. Hanafy
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Sherief M. Hussein
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Ola O. Abou Zeid
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Mohamed S. Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Ramadan M. Eldahshan
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Hesham A. Nada
- Department of Dermatology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Osama Sayedahmed
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Yasmin B. El Zawahry
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
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Rivera S, Flood A, Dykstra C, Herbenick D, DeMaria AL. Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3965-3979. [PMID: 35900677 PMCID: PMC9332093 DOI: 10.1007/s10508-022-02353-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/30/2022] [Accepted: 05/08/2022] [Indexed: 05/10/2023]
Abstract
Vulvar inflammatory dermatoses (VID; e.g., lichen sclerosus, lichen planus, vulvar dermatitis) can significantly impact sexual function. Both vulvar and non-vulvar inflammatory dermatoses (NVID; i.e., skin conditions not impacting vulvar skin, such as non-genital psoriasis and eczema/dermatitis) have yet to be fully characterized with regard to impact on genital self-image. A 20-min web-based survey was distributed September-November 2020 through social media ads, support groups, and online research recruitment services. Individuals in the USA over age 18 who were assigned female at birth and self-reported having been diagnosed with an inflammatory dermatosis were eligible. The primary outcome was the Female Genital Self-Image Scale (FGSIS). Secondary outcomes included the Female Sexual Function Index (FSFI), the Skindex-16 (a skin-related quality of life measure), the PROMIS Global-10 (assessing global physical/mental health), and sexual behavior histories. Participants (n = 348) reported mean age of 43.1 ± 15.5 (range = 19-81). Nearly one-third (n = 101; 29.0%) reported VID, 173 (50%) had NVID, and 74 (21%) experienced both vulvar and non-vulvar symptoms; they were analyzed as part of the VID group. The mean FGSIS score among participants with VID was 16.9 ± 4.1 and was significantly (p < .01) lower than that of participants with NVID (M = 21.2 ± 4.3), indicating lower genital self-image. Mental health (as measured by PROMIS-Global 10) was also impaired in VID. Rates of sexual dysfunction were high in both groups (> 60%). Findings suggest that in VID, lower genital self-image is correlated with poorer sexual function, quality of life, and global physical and mental health. Additional recommendations for VID management are proposed.
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Affiliation(s)
- Sydney Rivera
- Indiana University School of Medicine, 340 W. 10th St., Indianapolis, IN, 46202, USA.
| | - Anna Flood
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Chandler Dykstra
- Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Debby Herbenick
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, IN, USA
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10
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Van Overmeire R, Vesentini L, Vanclooster S, Bilsen J. Mental and sexual health communication experiences of people with psoriasis in Flanders, Belgium. J Eur Acad Dermatol Venereol 2022; 36:e814-e816. [PMID: 35652903 DOI: 10.1111/jdv.18288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/18/2022] [Indexed: 11/26/2022]
Affiliation(s)
- R Van Overmeire
- Mental Health and Wellbeing research group, Vrije Universiteit Brussel, Belgium
| | - L Vesentini
- Mental Health and Wellbeing research group, Vrije Universiteit Brussel, Belgium
| | - S Vanclooster
- Mental Health and Wellbeing research group, Vrije Universiteit Brussel, Belgium
| | - J Bilsen
- Mental Health and Wellbeing research group, Vrije Universiteit Brussel, Belgium
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11
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AlMutairi N, Eassa BI. A Randomized Controlled Ixekizumab Vs Secukinumab Trial to Study the Impact on Sexual Activity in Adult Patients with Genital Psoriasis. Expert Opin Biol Ther 2020; 21:297-298. [PMID: 33115285 DOI: 10.1080/14712598.2021.1843629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: There is limited data on the effects of biologic therapies on genital psoriasis and sexual activity. Recently, Ixekizumab was reported to be effective. Aim: To compare the efficacy of ixekizumab and secukinumab for the treatment of genital psoriasis and sexual inadequacy in adult patients with moderate-to-severe psoriasis. Patients and methods: We assessed adult patients with moderate-to-severe psoriasis having genital involvement. They were randomly assigned in a 1:1 ratio to receive either ixekizumab (80 mg/2 weeks after 160-mg initial dose) or secukinumab (300 mg subcutaneous injection at Weeks 0, 1, 2, 3, and 4 then every 4 weeks). The severity was assessed using Genital Psoriasis Symptoms Scale (GPSS), and impact on sexual health by evaluating the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ). Results: Twenty eight patients on ixekizumab, and 26 on secukinumab showed improvement in genital psoriasis symptoms, beginning week 2 (GPSS total and individual items), and from week 4 onwards, improvement in sexual activity was seen with both drugs. Conclusion: Both genital psoriasis symptoms and impact on sexual activity improved rapidly and significantly with both the IL-17 inhibitors. Limitations included small number of patients and lack of follow-up period.
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Affiliation(s)
- Nawaf AlMutairi
- Department of Medicine, Faculty of Medicine, Kuwait University , Kuwait City, Kuwait
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12
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Duvetorp A, Mrowietz U, Nilsson M, Seifert O. Psoriasis is Associated with a High Comedication Burden: A Population Based Register Study. Dermatol Ther (Heidelb) 2020; 10:1285-1298. [PMID: 32888181 PMCID: PMC7649200 DOI: 10.1007/s13555-020-00442-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction A large body of evidence supports the association between psoriasis and concomitant diseases. However, the study of comedication for these diseases in patients with psoriasis is limited. The current study aimed to investigate the prescription and drug dispensation for comorbidity associated with psoriasis. Methods We conducted a retrospective case-control study from 9 April 2008 until 1 January 2016 using an electronic medical records database covering the entire population of the County of Jönköping and the Swedish Prescribed Drug Register. ICD-10 and Anatomical Therapeutic Chemical codes were used to identify patients with psoriasis and dispensed pharmaceutical prescriptions. Individuals without psoriasis were selected as controls. Patients receiving systemic treatment for psoriasis were considered as having moderate-severe psoriasis. Odds ratios for being dispensed pharmaceutical prescriptions and differences in mean number of dispensed prescriptions were explored. Results A total of 4587 patients with psoriasis were identified in the medical records, and 268,949 individuals served as controls. Patients with psoriasis had a significantly higher number of different drug dispensations compared to controls. Only 1.3% of all patients with psoriasis were without any prescription (excluding medication for psoriasis) during the study period while the number in the general population was 9.3%. Sex- and age-adjusted odds ratios for dispensation of drug groups related to comorbid disease were significantly higher among patients with psoriasis including drug groups such as anxiolytics and sedatives as well as drugs targeting COPD, migraine and erectile dysfunction. The most frequently dispensed comedications were oral antibiotics and analgesics including an increased risk for dispensation of opioids. Sex predisposed dispensation frequency for a variety of drug groups. Drugs targeting obesity, osteoporosis, psychiatric disease and anti-mycotics/-fungals were more frequent among women. Conclusion Patients with psoriasis have significantly increased numbers of different dispensed prescriptions than those without psoriasis. This underlines previous findings on increased comorbidity and health care costs for patients with psoriasis. Electronic supplementary material The online version of this article (10.1007/s13555-020-00442-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Albert Duvetorp
- Division of Dermatology, Skåne University Hospital, Malmö, Sweden.
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
| | - Ulrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Mats Nilsson
- Futurum-Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Oliver Seifert
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Division of Dermatology and Venereology, Region Jönköping County, Jönköping, Sweden
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Soliman M. Patient-Reported Disease Severity and Quality of Life Among Arabic Psoriatic Patients: A Cross-Sectional Survey. Clin Cosmet Investig Dermatol 2020; 13:601-609. [PMID: 32943898 PMCID: PMC7473981 DOI: 10.2147/ccid.s269909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/04/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE Patient-reported measures are of importance in chronic dermatological conditions where psychosocial consequences and quality of life impairment are common. The current study aimed to evaluate patient-reported disease severity and quality of life in Arabic patients with psoriasis. PATIENTS AND METHODS Arabic psoriatic patients were invited to complete an online survey that collected patients' demographics, self-assessed Simplified Psoriasis Index (saSPI) and the Dermatology Life Quality Index (DLQI). Disease severity and quality of life were compared in relation to patients' demographics. Correlation between patient-reported measures was calculated using Spearman's rank correlation test. RESULTS A total of 221 patients with psoriasis, from 12 Arabic-speaking countries, participated in the study. The mean (95% CIs) saSPI-severity score was 10.9 (9.6-12.2). Female patients reported higher saSPI-psychosocial impact scores compared to males (P=0.04) while patients with longer disease duration reported higher saSPI-past history and interventions scores (P=0.0001). The mean (95% CIs) DLQI score was 11.2 (10.2-12.1). Patients with severe disease reported significantly higher DLQI scores [18.5 (10.5-2)] (P=0.0001). DLQI was strongly correlated with saSPI-psychosocial impact score (rho= 0.63). CONCLUSION Arabic psoriatic patients participating in this study showed mild to moderate disease severity which had a very large impact on patients' quality of life. Higher disease severity was associated with more impaired quality of life.
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Affiliation(s)
- Moetaza Soliman
- Department of Pharmacy Practice, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
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14
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Cuenca‐Barrales C, Montero‐Vílchez T, Szepietowski J, Matusiak L, Molina‐Leyva A. Sexual impairment in patients with hidradenitis suppurativa: a systematic review. J Eur Acad Dermatol Venereol 2020; 35:345-352. [DOI: 10.1111/jdv.16726] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - T. Montero‐Vílchez
- Instituto de Investigación Biosanitaria Granada Granada Spain
- Department of Dermatology and Venereology Hidradenitis Suppurativa ClinicHospital Universitario Virgen de las Nieves Granada Spain
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - L. Matusiak
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - A. Molina‐Leyva
- Instituto de Investigación Biosanitaria Granada Granada Spain
- Department of Dermatology and Venereology Hidradenitis Suppurativa ClinicHospital Universitario Virgen de las Nieves Granada Spain
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15
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Savel C, Cherillat MS, Berland P, Tronche AM, Soubrier M, Gerbaud L, Guiguet-Auclair C, Malochet Guinamand S. French survey on the crossed needs on sexual health for chronic inflammatory rheumatism patients and healthcare professionals. Rheumatol Int 2020; 40:1481-1491. [DOI: 10.1007/s00296-020-04630-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
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16
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Korman NJ, Malatestinic W, Goldblum OM, Murage MJ, Renda L, Lin CY, Lucas J, Middleton C, Lobosco S. Assessment of the benefit of achieving complete versus almost complete skin clearance in psoriasis: a patient's perspective. J DERMATOL TREAT 2020; 33:733-739. [PMID: 32432957 DOI: 10.1080/09546634.2020.1772454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Psoriasis is characterized by thick and scaly plaques. The Dermatology Life Quality Index (DLQI) and Physician Global Assessment (PGA) can be used to define its severity.Objective: To assess the impact of complete clearance of skin versus almost clear skin across various disease measures.Methods: Data were collected in a survey of US dermatologists and patients with psoriasis from November 2016-January 2017. Dermatologists completed a 6-point PGA (0 = clear skin, 1 = almost clear skin). Patients completed the DLQI and Work Productivity and Activity Impairment questionnaire (WPAI). Patients with clear and almost clear skin were compared using analysis of covariance for continuous variables, and multivariate logistic regression analysis for categorical variables.Results: Data for 99 and 160 patients with clear and almost clear skin, respectively, were included in the analyses. Patients with clear skin reported less frequent and lower intensity itching, lower total DLQI score (indicating better health-related quality of life), and less impairment of overall work productivity than patients with almost clear skin (all: p < 0.05).Limitations: Limitations relating to general survey methodology.Conclusion: Patients perceived a meaningful difference between clear and almost clear skin. Clear skin is now a realistic treatment target with newer biologics approved in psoriasis.
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Affiliation(s)
- Neil J Korman
- University Hospitals Case Medical Center, Cleveland, OH, USA
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17
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Restoux LJ, Dasariraju SR, Ackerman IN, Van Doornum S, Romero L, Briggs AM. Systematic Review of the Impact of Inflammatory Arthritis on Intimate Relationships and Sexual Function. Arthritis Care Res (Hoboken) 2020; 72:41-62. [PMID: 30941870 DOI: 10.1002/acr.23857] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review evidence of the impact of inflammatory arthritis on, or association of inflammatory arthritis with, intimate relationships and sexual function. METHODS Ovid Medline, Ovid PsycINFO, Ovid Embase, and EBSCO CINAHL databases were searched. Two independent reviewers selected articles, extracted data, and conducted manual searches of reference lists from included studies and previous reviews. The quality of evidence was assessed using standard risk-of-bias tools. RESULTS Fifty-five eligible studies were reviewed. Of these, 49 (89%) were quantitative, 5 (9.1%) were qualitative, and 1 (1.8%) used a mixed-method design. Few quantitative studies were rated as low risk of bias (n = 7 [14%]), many were rated as moderate (n = 37 [74%]) or high risk (n = 6 [12%]). Quantitative study sample sizes ranged from 10 to 1,272 participants, with a reported age range 32-63 years. Qualitative study sample sizes ranged from 8 to 57 participants, with a reported age range 20-69 years. In studies reporting the Female Sexual Function Index, all inflammatory arthritis groups demonstrated mean scores ≤26.55 (range of mean ± SD scores: 14.2 ± 7.8 to 25.7 ± 4.7), indicating sexual dysfunction. In studies reporting the International Index of Erectile Function, all inflammatory arthritis groups reported mean scores ≤25 (range of mean ± SD scores: 16.0 ± 5.3 to 23.8 ± 7.0), indicating erectile dysfunction. Key qualitative themes were impaired sexual function and compromised intimate relationships; prominent subthemes included inflammatory arthritis-related pain and fatigue, erectile dysfunction, diminished sexual desire, and sexual function fluctuations according to disease activity. CONCLUSION Sexual dysfunction appears highly prevalent among men and women with inflammatory arthritis, and increased clinician awareness of this impairment may guide provision of tailored education and support.
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Affiliation(s)
| | | | | | | | - Lorena Romero
- Alfred Medical Research and Education Precinct, Melbourne, Victoria, Australia
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18
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Kovitwanichkanont T, Chong AH, Foley P. Beyond skin deep: addressing comorbidities in psoriasis. Med J Aust 2020; 212:528-534. [PMID: 32388913 DOI: 10.5694/mja2.50591] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Psoriasis is a chronic inflammatory disease that is commonly encountered in primary care and is associated with significant morbidity that extends beyond the skin manifestations. Psoriasis is associated with an elevated risk of psoriatic arthritis, cardiovascular disease, obesity, insulin resistance, mental health disorders, certain types of malignancy, inflammatory bowel disease and other immune-related disorders, and hepatic and renal disease. Enhanced recognition of these comorbidities may lead to earlier diagnosis and potentially better overall health outcomes. Psoriatic nail involvement, severe skin disease and obesity are associated with a greater risk of psoriatic arthritis. Individuals with psoriasis should be routinely screened for psoriatic arthritis to allow for early intervention to improve long term prognosis. Life expectancy is reduced in people with psoriasis due to a variety of causes, with cardiovascular disease and malignancy being the most common aetiologies. Psoriasis affects several factors that contribute to worsened quality of life and increased risk of depression and anxiety. Effective therapies are now available that have been shown to concurrently improve skin disease, quality of life and psychiatric symptoms. As the concordance between psychosocial impact and objective disease severity does not always correlate, it is essential to tailor management strategies specifically to the needs of each individual. Cigarette smoking and excess alcohol consumption are among the most important modifiable risk factors that increase the likelihood of psoriasis development and severity of skin disease. This provides a compelling rationale for smoking cessation and limiting alcohol intake in people with psoriasis beyond their traditional harmful health consequences.
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Affiliation(s)
| | - Alvin H Chong
- Skin Health Institute, Melbourne, VIC.,St Vincent's Hospital, Melbourne, VIC
| | - Peter Foley
- Skin Health Institute, Melbourne, VIC.,St Vincent's Hospital, Melbourne, VIC
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Halioua B, Maccari F, Fougerousse AC, Parier J, Reguiai Z, Taieb C, Esteve E. Impact of patient psoriasis on partner quality of life, sexuality and empathy feelings: a study in 183 couples. J Eur Acad Dermatol Venereol 2020; 34:2044-2050. [PMID: 32173921 DOI: 10.1111/jdv.16270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/13/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The impact of psoriasis on quality of life (QoL), sexuality and empathy requires better understanding in patient-partner relationships. OBJECTIVES To evaluate the influence of psoriasis on partner QoL, presence of sexual dysfunction (SDy) in couples and empathy in partners of psoriasis patients. METHODS A total of 183 adult psoriasis patients and their partners participated in this observational, cross-sectional and non-comparative study. Severity of psoriasis was measured using the Psoriasis Area and Severity Index. Patient QoL was assessed using the Dermatology Life Quality Index and the Short Form-12 (SF12). The impact of psoriasis on partner QoL was measured with the Family Pso and the SF12. Presence of SDy and empathy in partners were assessed using the Family Pso. RESULTS Overall, 49.7% of the patients had moderate-to-severe psoriasis. Patient psoriasis severity and patient QoL were correlated with partner psychological distress. The largest QoL impairment was observed in female patients with moderate-to-severe psoriasis. The stronger QoL alteration observed in female psoriasis patients, compared to their partners, was not observed in male psoriasis patients vs. their partners. There was no relationship between partner QoL and patient age and duration of psoriasis. Most patients, but less than half of the partners, reported SDy with age being a being a significantly more important impacting factor than disease severity. Both psoriasis clinical severity and/or a significant impact on QoL were associated factors for SDy in male partners of psoriasis women, but not in female partners of psoriatic men. Reporting empathy was higher among young male partners of psoriasis patients. In both male and female partners, patient psoriasis clinical severity was not associated with empathy. CONCLUSIONS Psoriasis impact on patient-partner QoL, sexuality and empathy should be considered more thoroughly by dermatologists when formulating treatment plans and making treatment decisions.
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Affiliation(s)
- B Halioua
- GEM Resopso, Dermatology Center, Paris, France
| | - F Maccari
- Service de Dermatologie, Hopital d'Instruction des Armees Begin, Saint-Maur-des-Fossés, France
| | | | - J Parier
- Private Practice, Saint-Maur-des-Fossés, France
| | | | - C Taieb
- Necker Enfants Malades Hospital, Paris, France
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20
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Pozza A, Veale D, Marazziti D, Delgadillo J, Albert U, Grassi G, Prestia D, Dèttore D. Sexual dysfunction and satisfaction in obsessive compulsive disorder: protocol for a systematic review and meta-analysis. Syst Rev 2020; 9:8. [PMID: 31918750 PMCID: PMC6953228 DOI: 10.1186/s13643-019-1262-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/20/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a chronic mental health condition recognized as one of the most serious causes of disability and impaired quality of life. In the literature, there is no review about sexual dysfunction and satisfaction in OCD. The current paper presents the protocol for a systematic review and meta-analysis aimed to summarize data (1) comparing the presence of sexual dysfunction between groups with OCD and non-clinical groups, (2) investigating prevalence of each one of the sexual dysfunctions in patients with OCD, (3) comparing risk for sexual dysfunction in OCD groups with the prevalence in control groups, (4) comparing sexual satisfaction between OCD groups and non-clinical groups, and (5) investigating moderators of sexual dysfunction in OCD groups as compared with control groups. Gender, age, marital status, OCD symptom severity and subtypes, comorbid depressive disorders, comorbid anxiety disorders, concurrent psychiatric medications, comorbid general medical disease, and study quality will be investigated as moderators. METHODS The protocol is reported according to PRISMA-P guidelines. The search will be conducted by independent reviewers during the second week of December 2019 by using electronic databases (Scopus, PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Library), by contacting the authors of the included studies to identify further data, by examining the references of the included studies, and by handsearching conference proceedings and theses/doctoral dissertations. The study quality will be independently evaluated using the Newcastle-Ottawa Quality Assessment Scale. Random-effect meta-analyses will be computed. If there is insufficient data for a specific outcome, only a systematic review will be performed. DISCUSSION This review may support clinical practice highlighting the importance of the assessment of sexuality in patients with OCD and suggesting the use of therapeutic strategies dedicated to sexuality in this clinical population with the aim of improving patients' quality of life. Potential limitations will regard the heterogeneity of the studies in terms of the instruments used to assess sexual dysfunction/satisfaction and of the definitions used to conceptualize sexual dysfunction. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42019132264.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - David Veale
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
- South London and Maudsley, NHS Trust, London, UK
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Opthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa IRCCS San Martino, Genoa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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21
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Tonarelli L. Translating Knowledge of IL-23 Targeting into New Solutions for Psoriasis Treatment. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10314579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Following a brief introduction by Prof Lambert, the symposium started with an in-depth review of the current unmet needs in the clinical management of psoriasis, provided by Prof Radtke, who also reported on the multiple and cumulative negative effects of the condition on patients’ health, activity engagement, family relationships, and overall quality of life (QoL). Prof Radtke went on to describe the factors contributing to the burden of psoriasis, other than disease severity, and highlighted the importance of taking a holistic approach to the management of the condition that takes into consideration the individual patient’s expectations and needs. Prof Lambert continued the symposium with an overview of the core pathways involved in disease pathogenesis in relation to the development of novel targeted immunotherapies.
Prof Lambert reviewed the current clinical paradigms for the treatment of psoriasis, including targeted biological therapies, such as TNF-α inhibitors and newer agents acting on IL-17 and IL-23, which research shows may represent a more effective approach to the treatment of psoriasis and other autoimmune inflammatory disorders. The latest Phase III clinical trial data on therapies selectively targeting the upstream cytokine IL-23 were then presented by Dr Piaserico, with a focus on the monoclonal antibodies guselkumab, risankizumab, and tildrakizumab, and their potential to achieve consistent rates of skin clearance long-term, with the added benefit of prolonged dose intervals and intermittent treatment in some patients.
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22
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Psychological and Sexual Consequences of Psoriasis Vulgaris on Patients and Their Partners. J Sex Med 2019; 16:1900-1911. [DOI: 10.1016/j.jsxm.2019.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022]
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Langley RGB, Reich K, Strand V, Feldman SR, Paul C, Gordon K, Warren RB, Toth D, Nikaï E, Zhu B, Goldblum O, Edson-Heredia E, Carlier H, Burge R, Lin CY, Hollister K, Augustin M. Ixekizumab treatment and the impact on SF-36: results from three pivotal phase III randomised controlled trials in patients with moderate-to-severe plaque psoriasis. Qual Life Res 2019; 29:369-380. [PMID: 31655974 DOI: 10.1007/s11136-019-02296-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To assess improvements in health-related quality of life (HRQoL) with ixekizumab treatment in patients with moderate-to-severe psoriasis. METHODS Adults with plaque psoriasis were enrolled in phase III, double-blind, randomised, controlled trials (UNCOVER-1, UNCOVER-2, or UNCOVER-3). All 3 protocols included a 12-week, placebo-controlled induction period; UNCOVER-2 and UNCOVER-3 also had an active-control group (50 mg etanercept) during induction. After induction, patients in UNCOVER-1 and UNCOVER-2 entered a 48-week withdrawal (maintenance) period (Weeks 12-60), during which Week-12 sPGA (0,1) responders were rerandomized to receive placebo, or 80 mg ixekizumab every 4 weeks (Q4W) or 12 weeks. As a secondary objective, HRQoL was measured by the generic Medical Outcomes Survey Short Form-36 (SF-36) at baseline and Weeks 12 and 60. Changes in mean SF-36 Physical and Mental Component Summary (PCS and MCS) and domain scores and proportions of patients reporting improvements ≥ minimal important differences in SF-36 scores were compared between groups. RESULTS At Week 12, ixekizumab-treated patients (both dose groups in UNCOVER-1, -2, and -3) reported statistically significantly greater improvements in mean SF-36 PCS and MCS and all 8 SF-36 domain scores versus placebo. Further, more ixekizumab-treated patients than placebo-treated patients reported at least minimal treatment responses in SF-36 PCS and MCS scores and domain scores. Overall improvements in SF-36 PCS and MCS scores were maintained through Week 60. CONCLUSIONS Ixekizumab-treated patients reported statistically significant improvements in HRQoL at 12 weeks that persisted through 1 year.
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Affiliation(s)
- Richard G B Langley
- Division of Dermatology, Department of Medicine, Dalhousie University, 6054 Coburg Road, Halifax, NS, Canada.
| | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| | - Vibeke Strand
- Biopharmaceutical Consultant, Portola Valley, CA, USA
| | | | | | | | - Richard B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Darryl Toth
- Probity Medical Research, Windsor, ON, Canada
| | | | - Baojin Zhu
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | | | | | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg, Hamburg, Germany
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Cuenca-Barrales C, Molina-Leyva A. Risk Factors of Sexual Dysfunction in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. Dermatology 2019; 236:37-45. [PMID: 31434072 DOI: 10.1159/000501905] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/26/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) has a high impact on quality of life. However, sexual health has scarcely been investigated. OBJECTIVE To describe the frequency of sexual dysfunction (SD) in women and erectile dysfunction (ED) in men with HS and to explore potential risk factors. PATIENTS AND METHODS We conducted a cross-sectional study using a crowd-sourced online questionnaire spread by the Spanish hidradenitis suppurativa patients' association (ASENDHI). RESULTS In total, 393 participants answered the questionnaire. SD was found in 51% (95% CI 45-57%) of women and ED in 60% (95% CI 49-70%) of men. Factors related to SD were education status, patient's global assessment for disease activity, numeric rating scale for pain and unpleasant odour and the absence of a stable relationship. Factors related to ED were increasing age, the presence of active lesions in the genital area and the number of areas affected by active lesions. CONCLUSIONS There is a high prevalence of SD and ED in HS patients. Being in a stable relationship has been a protective factor of SD in women. The results suggest that sexual impairment in HS patients is due, at least in part, to disease activity, symptoms and active lesions.
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Affiliation(s)
| | - Alejandro Molina-Leyva
- Hidradenitis Suppurativa Clinic, Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain, .,European Hidradenitis Suppurativa Foundation (EHSF), Dessau-Roßlau, Germany, .,Instituto de Investigación Biosanitaria Granada, Granada, Spain,
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25
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Gonzalez‐Cantero A, Carretero G, Rivera R, Ferrándiz C, Daudén E, Cueva P, Gómez‐García F, Belinchón I, Herrera‐Ceballos E, Ruiz‐Genao D, Ferrán M, Alsina M, Sánchez‐Carazo J, Baniandrés O, Sahuquillo‐Torralba A, Rodriguez L, Vilar J, García C, Carrascosa J, Llamas‐Velasco M, Herrera‐Acosta E, López‐Estebaranz J, Botella‐Estrada R, Descalzo M, García‐Doval I. Women with moderate‐to‐severe psoriasis in Spain (
BIOBADADERM
registry) show more than a 50% reduction in age‐adjusted fertility rate when compared with the general population. Br J Dermatol 2019; 181:1085-1087. [DOI: 10.1111/bjd.18164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Cuenca-Barrales C, Ruiz-Villaverde R, Molina-Leyva A. Sexual Distress in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. J Clin Med 2019; 8:jcm8040532. [PMID: 31003427 PMCID: PMC6518250 DOI: 10.3390/jcm8040532] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 04/14/2019] [Accepted: 04/16/2019] [Indexed: 12/22/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin disease with a great impact in quality of life. However, there is little research about the impact of HS on sex life. The aims of this study are to describe the frequency of sexual distress (SD) in patients with HS and to explore potentially associated epidemiological and clinical factors. We conducted a cross-sectional study by means of a crowd-sourced online questionnaire hosted by the Spanish hidradenitis suppurativa patients’ association (ASENDHI). Sexual distress (SD) was evaluated with a Numeric Rating Scale (NRS) for HS impact on sex life. A total of 393 participants answered the questionnaire. The mean NRS for HS impact on sex life was 7.24 (2.77) in women and 6.39 (3.44) in men (p < 0.05). Variables significantly associated (p < 0.05) with SD in the multiple linear regression model were sex, with a higher risk in females, the presence of active lesions in the groin and genitals and NRS for pain and unpleasant odor; being in a stable relationship was an important protector factor. Regarding these results, it seems that SD in HS patients is due, at least in part, to disease symptoms and active lesions in specific locations, emphasizing the importance of disease control with a proper treatment according to management guidelines. Women and single patients are more likely to suffer from sexual distress.
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Affiliation(s)
- Carlos Cuenca-Barrales
- Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, Spain.
| | - Ricardo Ruiz-Villaverde
- Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, Spain.
| | - Alejandro Molina-Leyva
- Dermatology, Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain.
- European Hidradenitis Suppurativa Foundation (EHSF), 06847 Dessau-Roßlau, Germany.
- Instituto de Investigación Biosanitaria Granada, 18016 Granada, Spain.
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27
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Dauendorffer JN, Ly S, Beylot-Barry M. Psoriasis and male sexuality. Ann Dermatol Venereol 2019; 146:273-278. [DOI: 10.1016/j.annder.2019.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/17/2018] [Accepted: 01/15/2019] [Indexed: 02/08/2023]
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28
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Ribera M, Ros S, Madrid B, Ruiz-Villaverde R, Rebollo F, Gómez S, Loza E, Carretero G. Consensus Statement on the Psychological Needs of Patients With Chronic Inflammatory Skin Diseases. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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29
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Ribera M, Ros S, Madrid B, Ruiz-Villaverde R, Rebollo F, Gómez S, Loza E, Carretero G. Documento de consenso sobre las necesidades psicológicas de los pacientes con enfermedades inflamatorias crónicas dermatológicas. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:102-114. [DOI: 10.1016/j.ad.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 01/10/2023] Open
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30
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Elmets CA, Leonardi CL, Davis DMR, Gelfand JM, Lichten J, Mehta NN, Armstrong AW, Connor C, Cordoro KM, Elewski BE, Gordon KB, Gottlieb AB, Kaplan DH, Kavanaugh A, Kivelevitch D, Kiselica M, Korman NJ, Kroshinsky D, Lebwohl M, Lim HW, Paller AS, Parra SL, Pathy AL, Prater EF, Rupani R, Siegel M, Stoff B, Strober BE, Wong EB, Wu JJ, Hariharan V, Menter A. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol 2019; 80:1073-1113. [PMID: 30772097 DOI: 10.1016/j.jaad.2018.11.058] [Citation(s) in RCA: 235] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 02/08/2023]
Abstract
Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.
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Affiliation(s)
| | | | | | - Joel M Gelfand
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | - Nehal N Mehta
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | - Kelly M Cordoro
- Department of Dermatology, University of California San Francisco School of MedicineSan Francisco, California
| | | | | | - Alice B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York
| | | | | | | | | | - Neil J Korman
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Arun L Pathy
- Colorado Permanente Medical Group, Centennial, Colorado
| | | | - Reena Rupani
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Bruce E Strober
- University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Canada
| | - Emily B Wong
- San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio, Texas
| | - Jashin J Wu
- Dermatology Research and Education Foundation, Irvine, California
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31
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Merola JF, Shrom D, Eaton J, Dworkin C, Krebsbach C, Shah-Manek B, Birt J. Patient Perspective on the Burden of Skin and Joint Symptoms of Psoriatic Arthritis: Results of a Multi-National Patient Survey. Rheumatol Ther 2019; 6:33-45. [PMID: 30610650 PMCID: PMC6393265 DOI: 10.1007/s40744-018-0135-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Indexed: 12/20/2022] Open
Abstract
Introduction Psoriatic arthritis (PsA) and psoriasis (PsO) have a significant impact on HRQOL and work productivity loss. In patients with both PsA and PsO, the full extent of the physical and emotional burden of joint- and skin-related symptoms is less understood from the patient perspective. Methods A cross-sectional study of PsO patients with PsA from the US, France, and Germany was conducted using an online survey. Data on demographics, PsO severity by patient-reported body surface area involvement (BSA), PsA severity by RAPID3, impact of PsO and PsA using Patient Global Assessment (1–5), and novel questions exploring the emotional burden of joint/skin-related symptoms were collected. Multivariate regression analyses examined severity of joint and skin symptoms as predictors of quality of life (QoL), measured by PsAQoL, and Work Productivity and Activity Impairment (WPAI). Results Of the 439 patients, 23.9% had mild (RAPID3 of 0-2) and 76.1% had moderate–severe PsA (RAPID3 of 2.1–10), while 51% had mild and 49% had moderate–severe PsO (≥ 3 palms of the hand for BSA). Multivariate analyses showed that severity of joint symptoms was strongly associated with lower QoL (t = 13.15), followed by impact of skin symptoms (t = 5.11), and age (t = − 4.73), all p < 0.0001. About 57% of all patients reported a DLQI > 5, indicating a moderate-to-extremely large effect of psoriasis on HRQoL. Joint severity and impact of joint symptoms were the strongest predictors of WPAI. Patients also associated skin and/or joint symptoms with a variety of emotions and QoL measures that were not captured on the validated scales (fatigue, how they think of themselves, how others thought of them, making a first impression etc.). Conclusions In this study, both skin and joint symptoms had a broad, meaningful impact on patient QoL, work productivity, daily activities, and emotional well-being. These data highlighted the unique and significant impact of PsA among patients with PsO. Funding Eli Lilly and Company. Electronic supplementary material The online version of this article (10.1007/s40744-018-0135-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - David Shrom
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | | | - Julie Birt
- Eli Lilly and Company, Indianapolis, IN, USA
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32
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Hassanin AM, Ismail NN, El Guindi A, Sowailam HA. The emotional burden of chronic skin disease dominates physical factors among women, adversely affecting quality of life and sexual function. J Psychosom Res 2018; 115:53-57. [PMID: 30470317 DOI: 10.1016/j.jpsychores.2018.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/21/2018] [Accepted: 10/21/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Both physical and emotional effects are linked with the natural history of chronic skin diseases (CSD). Skin lesions can be confined to covered areas or involve emotionally charged regions (genitalia/exposed areas). OBJECTIVE To investigate the contribution of the physical effects of CSD and their emotional burden in adversely affecting the quality of life (QOL) and sexual function. METHODS Two groups were included: A group of women suffering from CSD and a control group. All participants answered the 19-item Female Sexual Function Index (FSFI) questionnaire. Women suffering from CSD answered the 10-item Dermatology Life Quality Index (DLQI) questionnaire; this group was divided into various subgroups according to the type of disease and regional involvement. RESULTS Neither the DLQI score (P = .06) nor the FSFI scores were significantly affected by the type of disease. The DLQI score was significantly higher in the subgroups with involvement of genitalia or exposed areas (P: < 0.001and 0.01, respectively). Moreover, genital involvement was associated with pervasive and significantly lower FSFI scores, and the arousal, satisfaction, and total scores were significantly lower among women with the involvement of exposed areas. The DLQI score was significantly negatively correlated with the FSFI scores. CONCLUSION The emotional burden of CSD should not be overlooked as it dominates the physical effects of disease by adversely affecting QOL and sexual function among women. It is necessary to provide this information to dermatologists and patients, especially in light of effective cognitive-behavior therapy that can be undertaken to ameliorate the emotional stresses.
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Affiliation(s)
- Ahmed Mohamed Hassanin
- Department of Andrology and Sexology, Faculty of Medicine, Cairo University, 1 Al-Saraya street, EL Manial, Cairo, 11559, Egypt.
| | - Nashaat Nabil Ismail
- Department of Andrology and Sexology, Faculty of Medicine, Beni-Suef University, 1 Latin America Street - Second Floor - Flat No. 10, Garden City, Egypt
| | - Ahmed El Guindi
- Department of Andrology and Sexology, Faculty of Medicine, Cairo University, 1 Al-Saraya street, EL Manial, Cairo, 11559, Egypt
| | - Hanan Amin Sowailam
- El-Houd El-Marsood Dermatology Hospital, Ministry of Health, Egypt; Department Of Dermatology, Faculty of Medicine, Beni-Suef University, Egypt
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33
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High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis. Int J Impot Res 2018; 31:74-84. [DOI: 10.1038/s41443-018-0093-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 02/06/2023]
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34
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Amanat M, Salehi M, Rezaei N. Neurological and psychiatric disorders in psoriasis. Rev Neurosci 2018; 29:805-813. [PMID: 29509545 DOI: 10.1515/revneuro-2017-0108] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/26/2018] [Indexed: 12/26/2022]
Abstract
Psoriasis used to be known as a skin disorder; however, it can now be considered as a systemic disease with the involvement of multiple organs. Neurological and psychiatric disorders are some of the associated problems that can be observed in patients with psoriasis. Stroke, multiple sclerosis, seizure, migraine, restless leg syndrome, Parkinson's disease, Guillain-Barré syndrome, and myasthenia gravis are the reported neurological diseases, while depression, bipolar mood disorder, anxiety, psychosis, cognitive impairment, personality disorders, sexual disorders, sleep disturbance, and eating disorders are the recognized psychiatric presentations in patients with psoriasis. Herein, the neurological and psychiatric disorders of psoriasis are described.
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Affiliation(s)
- Man Amanat
- NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran
| | - Mona Salehi
- NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran 14194, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran 14194, Iran.,Department of Immunology and Biology, School of Medicine, Tehran University of Medical Sciences, Tehran 14155-6447, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Boston, MA 1419733151, USA
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Larsabal M, Ly S, Sbidian E, Moyal‐Barracco M, Dauendorffer J, Dupin N, Richard M, Chosidow O, Beylot‐Barry M, Abdo I, Acquitter M, Breteque Mignot MA, Amici J, Archier E, Aubin F, Barthelemy H, Baubion E, Beneton N, Bolac C, Bouilly D, Bourseau‐Quetier C, Brenaut E, Buzenet C, Camus M, Celerier P, Chabbert C, Chamaillard M, Charles S, Darrigade A, Delarue M, Depaire F, Devaux S, Do‐Pham G, Duval‐Modeste A, Fabre F, Fauconneau A, Fite C, Fleuret C, Girard C, Grande S, Guillet S, Hacard F, Hegazy S, Hosteing S, Jacquin M, Jegou M, Joly P, Jouary T, Julien D, Kemula M, Kostrzewa E, Lacour J, Legrain V, Livideanu C, Lu D, Maccari F, Magne F, Martin C, Meunier L, Misery L, Parier J, Pelletier F, Perrussel M, Petit‐Fauconneau A, Peyrot I, Plantin P, Pruvost‐Balland C, Regnier E, Reynier‐Rezzi J, Salzes C, Seneschal J, Shollhammer M, Souteyrand A, Staumont D, Toulemonde A, Vanhaecke C, Vedie A, Versapuech J, Vigan M, Viguier M, Villani A. GENIPSO: a French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis. Br J Dermatol 2018; 180:647-656. [DOI: 10.1111/bjd.17147] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2018] [Indexed: 12/01/2022]
Affiliation(s)
- M. Larsabal
- Department of Dermatology Bordeaux University Hospital Bordeaux University Bordeaux France
| | - S. Ly
- Department of Dermatology Bordeaux University Hospital Bordeaux University Bordeaux France
- Vulvology Study Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
| | - E. Sbidian
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Department of Dermatology Henri‐Mondor Hospital, Public Assistance – Paris Hospitals (AP‐HP) CréteilFrance
- Virus,Immunity and Cancer University‐Hospital Complex (DHU VIC) EA 7379 Epidemiology in Dermatology and Evaluation of Treatments (EpiDermE) Paris‐Est University Créteil (UPEC) CréteilFrance
| | - M. Moyal‐Barracco
- Vulvology Study Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Department of Dermatology Cochin Tarnier Hospital Paris Descartes University ParisFrance
| | - J.‐N. Dauendorffer
- Vulvology Study Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Department of Dermatology Saint‐Louis Hospital Paris France
| | - N. Dupin
- Department of Dermatology Cochin Tarnier Hospital Paris Descartes University ParisFrance
- Dermatological Infectiology and Sexually Transmitted Diseases Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
| | - M.A. Richard
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Department of Dermatology Timone Hospital, Public Assistance–Marseille Hospitals Aix‐Marseille University UMR 911, INSERM CRO2, “Centre de recherche en oncologie biologique et oncopharmacologie” Marseille France
| | - O. Chosidow
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
- Department of Dermatology Henri‐Mondor Hospital, Public Assistance – Paris Hospitals (AP‐HP) CréteilFrance
- Virus,Immunity and Cancer University‐Hospital Complex (DHU VIC) EA 7379 Epidemiology in Dermatology and Evaluation of Treatments (EpiDermE) Paris‐Est University Créteil (UPEC) CréteilFrance
- Dermatological Infectiology and Sexually Transmitted Diseases Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
| | - M. Beylot‐Barry
- Department of Dermatology Bordeaux University Hospital Bordeaux University Bordeaux France
- Psoriasis Research Group of the French Society for Dermatology Maison de la Dermatologie Malherbes Paris France
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Sommerfleck FA, Schneeberger EE, Orozco MC, Zamora N, Landi M, Citera G. Validation and cultural adaptation of the qualisex questionnaire in patients with axial spondyloarthritis in Argentina. Rheumatol Int 2018; 38:2103-2109. [DOI: 10.1007/s00296-018-4148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/23/2018] [Indexed: 01/22/2023]
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Dauden E, Blasco AJ, Bonanad C, Botella R, Carrascosa JM, González-Parra E, Jodar E, Joven B, Lázaro P, Olveira A, Quintero J, Rivera R. Position statement for the management of comorbidities in psoriasis. J Eur Acad Dermatol Venereol 2018; 32:2058-2073. [PMID: 29992631 DOI: 10.1111/jdv.15177] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 07/02/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND The association between psoriasis and some diseases has become relevant in recent years. Providing appropriate management of psoriasis from an early stage requires prompt diagnosis and treatment of concomitant diseases and to prevent any potential comorbidity. This approach should consider the adverse events of the drugs used to treat psoriasis potentially related to the onset of comorbidities. OBJECTIVE To provide the dermatologist with an accurate and friendly tool for systematizing the diagnosis of psoriasis-associated comorbidities, which generally escapes the scope of the dermatology setting, and to facilitate decision-making about the referral and treatment of patients with comorbidities. METHODS These position statement recommendations were developed by a working group composed of ten experts (four dermatologists, one cardiologist, one rheumatologist, one gastroenterologist, one nephrologist, one endocrinologist and one psychiatrist) and two health services researchers. The expert group selected the psoriasis comorbidities considered according to their relevance in the dermatology setting. The recommendations on diagnostic criteria are based on the current clinical practice guidelines for each of the comorbidities. The information regarding the repercussion of psoriasis medical treatments on associated comorbid diseases was obtained from the summary of product characteristics of each drug. RESULTS Recommendations were developed to detect and refer the following psoriasis comorbidities: psoriatic arthritis, cardiovascular risk factors (diabetes, dyslipidaemia, obesity, hypertension and metabolic syndrome), non-alcoholic fatty liver disease, inflammatory bowel disease, kidney disease and psychological disorders (anxiety and depression). In addition, alcohol consumption and tobacco consumption were included. The tables and figures are precise, easy-to-use tools to systematize the diagnosis of comorbidities in patients with psoriasis and facilitate the decision-making process regarding referral and treatment of patients with an associated disease. CONCLUSION The application of these position statement recommendations will facilitate the dermatologist practice, and benefit psoriasis patients' health and quality of life.
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Affiliation(s)
- E Dauden
- Department of Dermatology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario de la Princesa, Madrid, Spain
| | - A J Blasco
- Independent Researcher in Health Services Research, Madrid, Spain
| | - C Bonanad
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - R Botella
- Department of Dermatology, Hospital Universitario la Fe, Valencia, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | | | - E Jodar
- Department of Endocrinology & Clinical Nutrition, Hospitales Universitarios Quirón Madrid & Ruber Juan Bravo, Universidad Europea de Madrid, Madrid, Spain
| | - B Joven
- Department of Rheumatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Lázaro
- Independent Researcher in Health Services Research, Madrid, Spain
| | - A Olveira
- Department of Gastroenterology and Hepatology, Hospital La Paz, Madrid, Spain
| | - J Quintero
- Department of Psychiatry, Hospital Infanta Leonor, Madrid, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Wu T, Duan X, Chen S, Chen X, Yu R, Yu X. Association Between Psoriasis and Erectile Dysfunction: A Meta-Analysis. J Sex Med 2018; 15:839-847. [PMID: 29735408 DOI: 10.1016/j.jsxm.2018.04.630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/30/2018] [Accepted: 04/10/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Several studies have shown a relationship between psoriasis and erectile dysfunction (ED), but a meta-analysis of the data has not been performed. AIM To conduct a comprehensive meta-analysis of existing evidence to quantify and compare the risk of ED with psoriasis. METHODS A systematic literature search was conducted using MEDLINE, EMBASE, Cochrane databases, and Google Scholar. We calculated pooled odds ratios (OR), standardized mean difference (SMD), and 95% CI. OUTCOMES Outcome measures included characteristics of included studies, association between psoriasis and ED risk, and association for adjusted-for-covariates studies between psoriasis and ED risk. RESULTS In total, 9 studies with 36,242 psoriasis patients and 1,657,711 controls (participants without psoriasis) met inclusion criteria and showed that there was statistically significant association between psoriasis and ED risk (OR 1.35; 95% CI 1.29-1.41; P < .00001; I2 = 44%). A significant association for adjusted-for-covariates studies between psoriasis and ED risk was also observed (OR 1.22; 95% CI 1.08-1.37; P = .002; I2 = 43.8%). It revealed the International Index of Erectile Function-5 score was statistically significantly lower in the psoriasis group than controls (SMD -3.09; 95% CI -4.81 to -1.37; P = .0004; I2 = 77%). A subgroup analysis was performed to potentially explain heterogeneity. It examined the main potential sources of inter-study variance including variance sample sizes and different assessment tools for ED. CLINICAL TRANSLATION The risk of ED in psoriasis patients should also be assessed by physicians. CONCLUSIONS This study is a well-designed and comprehensive meta-analysis to examine the relationship between psoriasis and risk of ED. However, the included studies are mostly cross-sectional or have small sample cohorts, which could bring bias and heterogeneity into the analysis. Our findings support the hypothesis that psoriasis is associated with an increased risk of ED. Furthermore, additional prospective cohort studies are needed to elucidate these relationships and to advance knowledge in this field. Wu T, Duan X, Chen S, et al. Association Between Psoriasis and Erectile Dysfunction: A Meta-analysis. J Sex Med 2018;15:839-847.
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Affiliation(s)
- Tao Wu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Xi Duan
- Department of Dermatovenereology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Shulin Chen
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Xiaobin Chen
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China
| | - Ruichao Yu
- Department of Pathophysiology and Molecular Pharmacology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Xiaodong Yu
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People's Republic of China.
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Abstract
Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8.9% to 68.7%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, have a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.
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Affiliation(s)
- Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L, Słomian A. Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients. Postepy Dermatol Alergol 2018; 35:60-66. [PMID: 29599673 PMCID: PMC5872236 DOI: 10.5114/pdia.2016.62287] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/21/2016] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Research has demonstrated a link between psoriasis and a multitude of psychological impairments; however, relatively few studies have examined the importance of site of skin lesions for negative psychological outcomes in psoriasis patients. AIM To investigate relationships between anatomical location of psoriatic lesions and experiences of stigmatization, negative emotional attitude towards the body, depression and social anxiety. MATERIAL AND METHODS Adult psoriasis patients (N = 193) completed the Stigmatization Scale, the Body Emotions Scale, the Beck Depression Inventory and the Social Anxiety Questionnaire. The body surface area index was used to assess the location and extent of psoriasis. RESULTS Feelings of stigmatization were found to be most closely related to the presence of psoriatic lesions on the chest, and the arms and hands. Higher levels of social anxiety were found to be most closely related to the location of psoriatic lesions on the head and neck. Negative emotional attitude towards the body was found to be most closely related to the location of psoriatic lesions on the arms and hands, and on the head and neck. Higher levels of depressive symptoms were most closely related to the presence of psoriatic lesions on the head and neck, the arms and hands, and the genital area. CONCLUSIONS The presence of psoriatic lesions on the head, neck, and chest, and also on the arms and hands and the genital area, should alert clinicians to a higher risk of psychological impairments. This may help to better recognize and prevent cumulative life course impairment.
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Affiliation(s)
- Patryk Łakuta
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Institute of Psychology, University of Silesia, Katowice, Poland
| | | | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
| | | | - Anna Słomian
- Group of Provincial Psychological Outpatients Clinics, Katowice, Poland
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Pottinger E, Woolf RT, Exton LS, Burden AD, Nelson-Piercy C, Smith CH. Exposure to biological therapies during conception and pregnancy: a systematic review. Br J Dermatol 2017; 178:95-102. [PMID: 28718898 DOI: 10.1111/bjd.15802] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Biological therapies are effective treatments for psoriasis and are often prescribed to women of child-bearing age. OBJECTIVES To evaluate the safety of biological therapy in conception and/or pregnancy. METHODS We performed a systematic review of PubMed, MEDLINE, Embase and Cochrane databases for multivariate-adjusted studies of women exposed to biologics relevant to the treatment of psoriasis during conception and/or pregnancy. RESULTS We identified four population-based cohort studies involving 1300 women exposed to tumour necrosis factor (TNF)-α inhibitors (TNFi) 3 months prior to or during the first 3 months of pregnancy. These studies showed a trend towards drug-specific harm with TNFi exposure in women with different inflammatory diseases, with an increased risk of congenital malformations [three studies; odds ratio (OR) range 1·32-1·64] and preterm birth (one study; OR 1·69, 95% confidence interval 1·10-2·60). This trend did not reach statistical significance in all studies; study heterogeneity, variation across comparator cohorts, inadequate adjustment for important confounding variables such as co-therapy, and an absence of a common constellation of malformations means there is uncertainty about the causal role of TNFi. No studies specifically addressed the effect of TNFi exposure in psoriasis during conception and/or pregnancy, or of interleukin (IL)-17 and IL-12/23 antagonists in any indication. CONCLUSIONS When counselling women these findings must be balanced against the potential impact of untreated severe psoriasis on conception and/or pregnancy and maternal wellbeing; ongoing pharmacovigilance via registries remains essential to address this evidence gap.
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Affiliation(s)
- E Pottinger
- National Guideline Centre, Royal College of Physicians, London, U.K
| | - R T Woolf
- St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, 9th Floor Tower Wing, King's College London, Guy's Hospital, Great Maze Pond, London, SE1 9RT, U.K
| | - L S Exton
- British Association of Dermatologists, London, U.K
| | - A D Burden
- Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, U.K
| | - C Nelson-Piercy
- Women's Health Academic Centre, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, U.K
| | - C H Smith
- St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, 9th Floor Tower Wing, King's College London, Guy's Hospital, Great Maze Pond, London, SE1 9RT, U.K
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Krychman M, Rowan CG, Allan BB, Durbin S, Yacoubian A, Wilkerson D. Effect of Single-Session, Cryogen-Cooled Monopolar Radiofrequency Therapy on Sexual Function in Women with Vaginal Laxity: The VIVEVE I Trial. J Womens Health (Larchmt) 2017; 27:297-304. [PMID: 29182498 PMCID: PMC5865245 DOI: 10.1089/jwh.2017.6335] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: This subanalysis of the VIVEVE I trial aimed to evaluate the impact of cryogen-cooled monopolar radiofrequency (CMRF) therapy, for the treatment of vaginal laxity, on the domains of sexual function included in the Female Sexual Function Index (FSFI). Materials and Methods: The VIVEVE I clinical trial was prospective, randomized, single-blind, and Sham-controlled. Nine clinical study centers in Canada, Italy, Spain, and Japan were included. This subanalysis included premenopausal women with self-reported vaginal laxity who had ≥1 term vaginal delivery and a baseline FSFI total score ≤26.5, indicating sexual dysfunction. Enrolled subjects were randomized (2:1) to receive CMRF therapy [Active (90 J/cm2) vs. Sham (≤1 J/cm2)] delivered to the vaginal tissue. Independent analyses were conducted for each FSFI domain to evaluate both the mean change, as well as the clinically important change for Active- versus Sham-treated subjects at 6 months post-intervention. Results: Subjects randomized to Active treatment (n = 73) had greater improvement than Sham subjects (n = 35) on all FSFI domains of sexual function at 6 months postintervention. The analysis of covariance change from baseline analyses showed statistically significant improvements, in favor of Active treatment, for sexual arousal (p = 0.004), lubrication (p = 0.04), and orgasm (p = 0.007). In addition, Active treatment was associated with clinically important and statistically significant improvements in sexual desire [Odds ratio (OR) = 3.01 (1.11–8.17)], arousal [OR = 2.73 (1.06–7.04)], and orgasm [OR = 2.58 (1.08–6.18)]. Conclusions: This subanalysis showed CMRF therapy is associated with statistically significant and clinically important improvements in sexual function in women with vaginal laxity. These findings provide the first randomized, placebo-controlled energy-based device evidence for functional improvements associated with a nonsurgical modality for a highly prevalent and undertreated condition.
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Affiliation(s)
- Michael Krychman
- 1 Southern California Center for Sexual Health and Survivorship Medicine , Newport Beach, California
| | - Christopher G Rowan
- 2 Collaborative Healthcare Research and Data Analytics (COHRDATA) , Santa Monica, California
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Guenther L, Warren RB, Cather JC, Sofen H, Poulin Y, Lebwohl M, Terui T, Potts Bleakman A, Zhu B, Burge R, Reich K, van de Kerkhof P. Impact of ixekizumab treatment on skin-related personal relationship difficulties in moderate-to-severe psoriasis patients: 12-week results from two Phase 3 trials. J Eur Acad Dermatol Venereol 2017; 31:1867-1875. [PMID: 28573743 DOI: 10.1111/jdv.14377] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/04/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psoriasis symptoms may decrease quality of life for patients. Skin-related personal relationship difficulties in psoriasis patients are common, under-reported and poorly understood. OBJECTIVE To assess the effect of ixekizumab (IXE) treatment on skin-related personal relationship difficulties in patients with moderate-to-severe psoriasis. METHODS Pooled data (N = 2570) on skin-related relationship problems were obtained from two large phase 3 trials (UNCOVER-2 and UNCOVER-3) in patients with moderate-to-severe plaque psoriasis randomized to subcutaneous placebo (PBO, N = 361), etanercept (ETN; 50 mg twice weekly, N = 740), or 80 mg IXE as one injection every 4 (IXEQ4W, N = 733) or 2 weeks (IXEQ2W, N = 736) for 12 weeks, following a 160-mg initial dose. The Dermatology Life Quality Index (DLQI) Personal Relationships Domain (PRD) (Items 8 and 9) was used to assess how much the skin caused any personal relationship difficulties at weeks 0, 2, 4 and 12. Improvement was compared for IXE vs PBO and ETN using logistic models. Factors associated with improvement were assessed using multiple linear regressions. DLQI Item 9, assessing sexual difficulties, was also analysed separately. RESULTS PRD scores (mean ± standard deviation) at baseline were similar across all treatment groups (PBO: 1.8 ± 1.9; ETN: 1.7 ± 1.8; IXEQ4W: 1.6 ± 1.8; IXEQ2W: 1.7 ± 1.8). Treatment with IXE rapidly and significantly improved the mean PRD score compared to PBO and ETN (P < 0.001 at all time points). Baseline PRD score was the strongest negative predictor of improvement. IXE enabled significantly more patients with moderate-to-severe plaque psoriasis to reduce their skin-related sexual difficulties at Week 12 compared to PBO (P < 0.001) or ETN (P < 0.001). CONCLUSION Ixekizumab improves patient-reported skin-related PRD difficulties in patients with moderate-to-severe psoriasis.
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Affiliation(s)
| | - R B Warren
- The Dermatology Centre, Salford Royal Foundation Hospital, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - J C Cather
- Modern Research Associates, Dallas, TX, USA
| | - H Sofen
- Department of Medicine/Dermatology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Y Poulin
- Centre de Recherche Dermatologique du Québec Métropolitain, Quebec, Canada.,Laval University, Quebec, Canada
| | - M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T Terui
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | | | - B Zhu
- Eli Lilly and Company, Indianapolis, IN, USA
| | - R Burge
- Eli Lilly and Company, Indianapolis, IN, USA.,Division of Pharmaceutical Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - K Reich
- Dermatologikum Hamburg and SCIderm Research Institute, Hamburg, Germany
| | - P van de Kerkhof
- Department of Dermatology, Radboud University Nijmegen, Nijmegen, The Netherlands
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44
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Doumas M, Katsiki N, Papademetriou V. Psoriasis and Cardiovascular Disease: Two Sides of the Same Coin? Angiology 2017; 69:5-9. [PMID: 28401789 DOI: 10.1177/0003319717702303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michael Doumas
- 1 Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.,2 VAMC and George Washington University, Washington, DC, USA
| | - Niki Katsiki
- 1 Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Vasilios Papademetriou
- 1 Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.,3 VAMC and Georgetown University, Washington, DC, USA
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45
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Torre-Alonso JC, Carmona L, Moreno M, Galíndez E, Babío J, Zarco P, Linares L, Collantes-Estevez E, Barrial MF, Hermosa JC, Coto P, Suárez C, Almodóvar R, Luelmo J, Castañeda S, Gratacós J. Identification and management of comorbidity in psoriatic arthritis: evidence- and expert-based recommendations from a multidisciplinary panel from Spain. Rheumatol Int 2017; 37:1239-1248. [DOI: 10.1007/s00296-017-3702-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/14/2017] [Indexed: 02/08/2023]
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46
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Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, Gelfand JM. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol 2017; 76:377-390. [PMID: 28212759 PMCID: PMC5731650 DOI: 10.1016/j.jaad.2016.07.064] [Citation(s) in RCA: 601] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 02/08/2023]
Abstract
Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.
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Affiliation(s)
- Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Sungat Grewal
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sinéad M Langan
- London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom
| | - Nehal N Mehta
- National Heart, Lung and Blood Institute, Bethesda, Maryland
| | - Alexis Ogdie
- Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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47
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Egeberg A, Hansen PR, Gislason GH, Skov L, Thyssen JP. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis. J Sex Med 2017; 14:380-386. [DOI: 10.1016/j.jsxm.2016.12.233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/20/2016] [Accepted: 12/24/2016] [Indexed: 11/25/2022]
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48
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Young M, Aldredge L, Parker P. Psoriasis for the primary care practitioner. J Am Assoc Nurse Pract 2017; 29:157-178. [PMID: 28233460 DOI: 10.1002/2327-6924.12443] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/15/2016] [Accepted: 12/16/2016] [Indexed: 01/23/2023]
Abstract
Primary care practitioners (PCPs) are playing an increasingly important role in the management and care of psoriasis. Thus, it is important for PCPs to be knowledgeable about the disease and to be able to differentiate between common myths and facts related to diagnosis and treatment. By building relationships with their patients and working collaboratively with dermatology health professionals and other specialists, PCPs can facilitate communication about the patient's treatment preferences and expectations for symptom relief, and they may be better able to work with the patient to optimize treatment adherence. This review aims to provide PCPs with a primer on psoriasis, its associated comorbidities, and its impact on patients' quality of life. Discussion topics include psoriasis epidemiology, triggering factors, clinical presentation, differential diagnosis, comorbidities, and approaches to treatment. This review also highlights the importance of staying abreast of advances in the understanding of psoriasis pathogenesis as well as emerging therapeutic treatment options, because these advances may change the treatment landscape and increase patients' expectations for skin clearance.
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Affiliation(s)
- Melodie Young
- Modern Dermatology, Baylor-Health Texas Affiliate, Dallas, Texas
| | - Lakshi Aldredge
- Dermatology Service, Operative Care Division, VA Portland Health Care System, Portland, Oregon
| | - Patti Parker
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas
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49
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Acceptance of psoriasis in the context of body image, body experience, and social support. HEALTH PSYCHOLOGY REPORT 2017. [DOI: 10.5114/hpr.2017.63824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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50
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Chiu HY, Wang IT, Huang WF, Tsai YW, Tsai TF. Risk of varicocele in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic disease: a population-based case-control study. Scand J Rheumatol 2016; 46:411-413. [PMID: 27973977 DOI: 10.1080/03009742.2016.1245779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H-Y Chiu
- a Institute of Biomedical Engineering, College of Medicine and College of Engineering , National Taiwan University , Taipei , Taiwan.,b Department of Dermatology , National Taiwan University Hospital Hsin-Chu Branch , Hsinchu , Taiwan.,c Department of Dermatology , National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan
| | - I-T Wang
- d Department of Physical Therapy and Assistive Technology , National Yang-Ming University , Taipei , Taiwan
| | - W-F Huang
- e Institute of Health and Welfare Policy , National Yang-Ming University , Taipei , Taiwan
| | - Y-W Tsai
- e Institute of Health and Welfare Policy , National Yang-Ming University , Taipei , Taiwan
| | - T-F Tsai
- c Department of Dermatology , National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei , Taiwan
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