Dermatology Update 2017 Fall
SESSIONS & ABSTRACTS
VANCOUVER, FAIRMONT WATERFRONT HOTEL - OCTOBER 26-29, 2017
Genital Psoriasis: The Disease and Its Treatment
Although up to ½ of patients with psoriasis report having had genital involvement at some point, the disease is often underappreciated by health care providers and inappropriately self-treated. Patients whose psoriasis onsets at an earlier age and those with more severe disease, scalp disease, nail disease, axillary, or inframammary disease, and males, are at increased risk. Lesions on both the penis and vulva are typically well-demarcated, bright red and thin, with minimal scale. Lesions are often mistaken for fungal infections or dermatitis. Pain and itching are common. Patients with genital psoriasis have worse quality of life compared to those without it. It negatively impacts sexual function and frequency.
There is a paucity of published trials on treatments for genital psoriasis. The thin sensitive genital skin puts it at risk for adverse effects of topical treatment. Systemic treatment has been generally reserved for severe, extensive genital psoriasis, or disease with a large impact on quality of life. In a placebo-controlled trial, ixekizumab rapidly cleared genital skin regardless of the baseline body surface area, improved itching and minimized how often genital psoriasis limited the frequency of sexual activity.