PS56 Beyond the skin: sexual dysfunction and quality of life in psoriasis

Abstract

Psoriasis is a chronic inflammatory skin disease with significant psychosocial consequences. Beyond physical symptoms, altered body image, stigmatization and emotional distress may significantly impair intimacy and sexual wellbeing. We aimed to evaluate the impact of psoriasis on sexual function and quality of life compared with individuals without dermatological disease, and to assess the relationships between disease severity, treatment response and changes in sexual wellbeing over time. This multicentre matched cohort study includes adult patients with psoriasis and age- and sex-matched controls without dermatological disease. Sexual function was assessed using validated, sex-­specific questionnaires (Sexual Quality of Life Questionnaire for Men, Female Sexual Distress Scale-Revised, Female Sexual Function Index-6 and International Index of Erectile Function-5, as appropriate) alongside quality-of-life measures. Disease severity was evaluated using the Physician’s Global Assessment, Psoriasis Area and Severity Index, and body surface area at baseline, week 4 and week 24. Multivariable regression and mixed-effects models were used to analyse associations between disease activity, treatment and sexual health outcomes. Sexual dysfunction was observed in > 50% of patients with psoriasis. Higher disease burden was associated with poorer quality of life, including impaired sexual wellbeing. Greater disease severity, assessed using Psoriasis Area and Severity Index and Dermatology Life Quality Index scores, was associated with increased sexual distress and worse sexual functioning. Patients with more severe disease more frequently reported shame related to skin lesions, concerns regarding partner perception, and avoidance of sexual intimacy. Improvement in skin disease activity over follow-up was associated with improvements in sexual wellbeing. Sexual dysfunction represents a frequent and clinically relevant component of psoriasis-related disease burden. Effective treatment was associated with improvement in skin disease activity, patient self-perception and sexual wellbeing. These findings support integrating sexual health assessment into routine psoriasis management to promote truly patient-centred care.