Purpose: Psoriatic disease (PsO) involving the genital region (GenPsO) or areas of sexual interest (ASI; anal region, gluteal area, groin, lower back, and chest/breast) is associated with impaired quality of life (QoL), sexual burden, and avoidance of sexual life. This nested cohort study investigated the prevalence and effect of GenPsO and PsO at any ASI in routine German care. Methods: Adult patients enrolled in the PsoBest registry were surveyed by mail. Main endpoints were prevalences of GenPsO and PsO at any ASI in the past 12 and 24 months. The reasons for sexual impairment (RSI) questionnaire, the Genital Psoriasis Symptoms Scale (GPSS), the Genital Psoriasis Sexual Impact Scale, demographics, and disease characteristics were assessed. Results: Questionnaires were returned by 811/2010 (40.3%) patients; 795 (39.6%) complete sets were analyzed. Mean (SD) age at onset was 35.0 (14.0) years for GenPsO, and 34.1 (14.9) years for PsO at any ASI. Period prevalence was 21.6% (n=172) for GenPsO and 49.2% (n=391), for PsO at any ASI in the last 24 months, and 10.8% (n=86) and 26.7% (n=212), respectively, at day of survey. Systemic therapy was used by 84.9% (n=73) of patients with GenPsO and 83.0% (n=176) with PsO at any ASI. Mean (SD) GPSS sum score was 27.6 (18.6). In the past 30 days, 60.5% (n=52) of patients with GenPsO and 35.4% (n=75) with PsO at any ASI experienced sexual impairment. Among patients with GenPsO, 40.7% (n=35) reported always avoiding sexual activities during the past week. RSI included stress, lack of self-confidence, and PsO-related pain/movement restrictions. Conclusion: Given the high prevalence of GenPsO and its extensive effect on patient QoL and sexual well-being, it is essential that genital and ASI regions are examined at each routine clinical appointment and that appropriate treatment is offered to minimize negative consequences and cumulative life course impairment.
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