GENIPSO: a French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis

Larsabal, M.; Ly, Sandra; Sbidian, É.; Moyal‐Barracco, Micheline; Dauendorffer, J.‐N.; Dupin, Nicolas; Richard, M.‐A.; Chosidow, O.; Beylot‐Barry, M.

doi:10.1111/bjd.17147

Cited by 55 publications

(47 citation statements)

References 31 publications

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“…The prevalence of psoriasis in hard-to-treat areas differs greatly across studies. For example, one French study [29] of 776 patients with psoriasis from two tertiary centres found that 43.2% of patients currently had genital psoriasis. This prevalence is somewhat higher compared to the findings of our and previous studies.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort

et al. 2020

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Background: Having psoriasis in hard-to-treat areas, i.e. the scalp, face, palms, soles, nails, and genitals, respectively, can impair patients' quality of life. We investigated the prevalence of hard-to-treat body locations of psoriasis, and described patients' clinical and demographic characteristics, and quality of life impacts in a population-based cohort. Methods: We performed a cross-sectional study using a total of 4016 adults (≥18 years) with psoriasis from the Danish Skin Cohort. Groups were compared to patients without involvement of hard-to-treat areas. Results: The most frequently affected hard-to-treat area was the scalp (43.0%), followed by the face (29.9%), nails (24.5%), soles (15.6%), genitals (14.1%), and palms (13.7%), respectively. Higher prevalence was generally seen with increasing psoriasis severity. Among all patients 64.8, 42.4, and 21.9% of patients had involvement of ≥1, ≥2, or ≥ 3 hard-to-treat areas. Those with involvement of certain hard-to-treat areas such as hands, feet, and genitals had clinically relevant DLQI impairments. Having involvement of one hard-to-treat area was significantly associated with other hard-to-treat areas affected even after adjusting for age, sex, and psoriasis severity. Conclusion: Psoriasis commonly affects hard-to-treat locations, even in patients with mild disease. For some of these areas, patient-reported disease burden, e.g. as measured by DLQI, is impaired.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort

et al. 2020

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“…Although genital psoriasis is a common manifestation of plaque psoriasis associated with reduced quality of life and sexual health (2,3,7), it is frequently overlooked in clinical practice (7)(8)(9), and there have been few clinical studies evaluating therapies for genital psoriasis (4,14,(16)(17)(18). Hence, well-established treatment options for genital psoriasis are limited and awareness among both healthcare providers and patients is limited.…”

Section: Discussionmentioning

confidence: 99%

“…Genital psoriasis may present to multiple medical disciplines including primary care, dermatology, venereology, gynecology, urology, and sexual medicine (6). Despite the high prevalence and burden of genital psoriasis, approximately 46% of patients do not discuss their genital symptoms with their healthcare providers and only 40% of patients indicate having been examined for genital involvement (7)(8)(9). Thus, there is currently an unmet need for increased awareness of genital psoriasis among both patients and physicians to encourage appropriate diagnosis and treatment.…”

mentioning

confidence: 99%

Ixekizumab Results in Persistent Clinical Improvement in Moderate-to-Severe Genital Psoriasis During a 52 Week, Randomized, Placebo-Controlled, Phase 3 Clinical Trial

Guenther¹,

Bleakman²,

Weisman³

et al. 2020

Acta Derm Venerol

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Genital skin is commonly affected among patients with psoriasis. Genital psoriasis can cause problems such as genital itch and pain, and have negative effects on mental, social, and sexual health. Ixekizumab, can provide significant relief of genital psoriasis within 12 weeks of starting treatment. This study showed that patients with genital psoriasis continue to have symptom relief after one year of treatment with ixekizumab. Ixekizumab was efficacious in treating moderate-tosevere genital psoriasis over 12 weeks. We evaluated the long-term efficacy and safety of ixekizumab for up to 52 weeks. Patients were randomized to 80 mg ixekizumab every 2 weeks or to placebo through Week 12, then received 80 mg open-label ixekizumab every 4 weeks through Week 52. In patients initially randomized to ixekizumab, clear or almost clear genital skin was achieved for 73% of patients at Week 12 and 75% at Week 52. Persistent improvements were also observed for overall psoriasis, genital itch, and the impact of genital psoriasis on the frequency of sexual activity. The safety profile was consistent with studies of ixekizumab in patients with moderate-to-severe plaque psoriasis. Ixekizumab provided rapid and persistent improvements in the signs and symptoms of genital psoriasis for up to 52 weeks of treatment.

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“…Although the prevalence of exclusive genital psoriasis is estimated at 2-5% of all patients with psoriasis, 31% of patients in the current sample reported lesions in the anal and/or genital areas. The prevalence of anogenital psoriasis reported in previous studies is probably underestimated, since a large portion of patients have reported they had not been examined previously for genital involvement [28,29]. The substantial proportion of patients with anogenital psoriasis in the present study resembles those found in the few previous studies on the epidemiology of psoriasis of the genital skin [5] and may be justified by the use of a patient-reported grid scheme to document the topology of psoriasis, which enabled the patients to disclose the involvement of anogenital areas regardless of whether they have previously discussed this sensitive topic with their physicians.…”

Section: Plos Onementioning

confidence: 99%

Sex-related impairment and patient needs/benefits in anogenital psoriasis: Difficult-to-communicate topics and their impact on patient-centred care

et al. 2020

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Genital psoriasis affects 2-5% of psoriasis patients; generalised plaque or intertriginous psoriasis also affects the genital area in 29-40% of cases. Anogenital psoriasis has been associated with significant quality of life impairments, but little is known about specific patient needs/treatment goals. This study aimed to examine the overall and sex-related disease burden, patient needs and treatment benefits in patients with anogenital psoriasis, compared to patients with psoriasis not affecting the anal/genital areas. Within the cross-sectional nationwide survey, 2,009 participants were consecutively recruited in 157 randomly assigned German dermatology practices and clinics, according to the following inclusion criteria aged 18 years or over; diagnosis of psoriasis vulgaris; ability to answer the questionnaires; and written informed consent. Based on a high-resolution grid on the topical distribution of psoriasis, two groups were formed: anogenital psoriasis (n = 622) and comparison group (n = 1,303). Clinical severity was assessed by the Psoriasis Area and Severity Index (PASI). Patients completed the EuroQoL visual analogue scale (EQ VAS), the Dermatology Life Quality Index (DLQI), and the Patient Benefit Index (PBI). Patients with anogenital psoriasis had higher PASI (13.0±10.6 vs. 8.9±7.6, P < 0.001) and more DLQI impairments (8.9±6.9 vs. 7.0±6.2, P = 0.002) than controls. At the item-level, they also reported more sex-related DLQI impairments (DLQI-i9: 0.5±0.8 vs. 0.3±0.7, P < 0.001) and treatment needs (PBI-i17: 2.2±1.8 vs. 1.9±1.8, P = 0.001). A great percentage of missing/not-relevant responses was found for sex-related items (23.3-41.9%). These results suggest that the assessment of sex-related impairments and treatment needs should be prioritised in patients with anogenital psoriasis. Questionnaires may be used as a less uncomfortable way for patients to discuss their genital lesions and sexual function during healthcare visits. However, the great percentage of missing/not-relevant

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GENIPSO: a French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis

Abstract: Genital psoriasis has a high prevalence in patients consulting for extragenital psoriasis, which affects QoL, and should be taken into account by dermatologists in order to optimize global care.

Cited by 55 publications

References 31 publications

Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort

Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort

Ixekizumab Results in Persistent Clinical Improvement in Moderate-to-Severe Genital Psoriasis During a 52 Week, Randomized, Placebo-Controlled, Phase 3 Clinical Trial

Sex-related impairment and patient needs/benefits in anogenital psoriasis: Difficult-to-communicate topics and their impact on patient-centred care

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