Increased Risk of Sexual Dysfunction in Male Patients with Psoriasis: A Nationwide Population-Based Follow-Up Study

Abstract

Introduction An association between psoriasis and sexual dysfunction (SD) has been explored. However, the risk of SD after the diagnosis of psoriasis relative to the age-matched general population remains unknown. Aim To clarify the risk of developing SD in male patients with psoriasis. Methods From 2000 to 2001, we identified 12,300 male patients with newly diagnosed psoriasis and 61,500 matching controls from National Health Insurance Database in Taiwan. Main Outcome Measures The two cohorts were followed up until 2008, and we observed the occurrence of SD by registry of SD diagnosis in the database. Stratified Cox proportional hazard regressions were used to calculate the 7-year SD risk for these two groups. Results Of the 73,800 sampled patients, 1,812 patients (2.46%) experienced SD during the 7-year follow-up period, including 373 (3.03% of patients with psoriasis) in the study group and 1,439 (2.34% of patients without psoriasis) in the comparison group. The hazard ratio (HR) for SD for patients with psoriasis was 1.27 times (95% confidence interval [CI], 1.11–1.46; P = 0.001) as high as that for patients without psoriasis after adjusting for age, monthly income, number of health-care visits, systemic treatment, and other comorbidities. Stratified analysis showed that the risk of SD was higher in patients older than 60 years old (HR: 1.42, 95% CI: 1.12–1.81) and patients with psoriatic arthritis (HR: 1.78, 95% CI: 1.08–2.91). However, the risk of SD was not significantly elevated in patients receiving systemic treatment, including retinoid, methotrexate, and cyclosporine. Conclusions Male patients with psoriasis are at increased risk of developing SD. Physicians should pay attention to the impact of psoriasis on psychosocial and sexual health, especially in old-aged patients.

Prevalence and Associated Factors of Erectile Dysfunction in Patients With Moderate to Severe Psoriasis and Healthy Population: A Comparative Study Considering Physical and Psychological Factors

“…No study to date has investigated the role of anxiety and depression on ED in psoriasis patients. It is possiblethat the association found in many studies between psoriasis and ED could be mediated by the higher prevalence of anxiety and depression present in psoriasis patients compared to controls that were not considered in these investigations (Table 1) (Cabete et al, 2014;Chen et al, 2013;Chung et al, 2012). Thus, special attention should be given to psychological impairment in the therapeutic approach of ED in psoriasis patient.…”

“…Inourstudy,weobserved that smoking is involved in a greater risk of ED and is more prevalent among moderate to severe psoriasis patients. Other studies have found a significant association between arterial hypertension, dyslipidemia or diabetes mellitus and ED in patients with psoriasis (Table 1) (Cabete et al, 2014;Chen et al, 2013;Chung et al, 2012;Goulding et al, 2011). These factors, such as smoking, anxiety, and depression, are more prevalent among psoriasis patients than in the general population and are also associated with a higher risk of ED (Corona, Mannucci, Forti, & Maggi, 2009;Martin-Morales et al, 2001;Nunes, Labazi, & Webb, 2012).…”

“…However, the results are not con sistent when taking into account risk factors already known to be associated with ED (Table 1). Some studies observed that psoriasis per se is associated independently with ED, arguing that chronic systemic inflammation impairs erectile function (Cabete et al, 2014;Chen et al, 2013;Chung, Keller, Chu, & Lin, 2012). Other investigators found no direct relationship, attributing their results to the accumulation of other risk factors for ED such as arterialhypertension (Goulding etal., 2011;TurelErmertcan etal., 2006).…”

Association between psoriasis and asthma: a population-based retrospective cohort analysis

“…Psoriasis is a type of chronic inflammatory dermatosis that can restrict patients' work, and social, family, leisure and sexual activities . Psoriasis is associated with multiple comorbidities, and has been described as a systemic chronic inflammatory disorder .…”

Is sexology necessary in dermatology? Review of most common sexual dysfunction in skin disorders

“…In the terms of medicamentous therapy, some studies about sexual dysfunction in psoriasis have been reported, especially sexual impotence and erectile dysfunction due to the medicamentous therapy, such as etretinate and methotrexate [14,15]. However, there is a study which showed that the risk of sexual dysfunction was not significantly elevated in patients receiving systemic treatment, including retinoid, methotrexate, and cyclosporine [16].…”