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

da Silva, Neuza
Augustin, Matthias
Langenbruch, Anna
Mrowietz, Ulrich
Reich, Kristian
Thaçi, Diamant
Kirsten, Natalia
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Published in PLOS ONE. 2020, vol. 15, no. 7, e0235091
Abstract 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 responses to sex-related items calls for in-depth assessments and effective patient-physician communication regarding these sensitive topics.
Keywords AdolescentAdultAgedAnal Canal/pathologyCross-Sectional StudiesFemaleGenitalia/pathologyHumansMaleMiddle AgedPatient-Centered CarePhysician-Patient RelationsPsoriasis/epidemiology/pathologyQuality of LifeSeverity of Illness IndexSex FactorsYoung Adult
PMID: 32609733
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Research group Mécanismes des pathologies de l'inflammation cutanée (919)
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DA SILVA, Neuza et al. Sex-related impairment and patient needs/benefits in anogenital psoriasis: Difficult-to-communicate topics and their impact on patient-centred care. In: PLOS ONE, 2020, vol. 15, n° 7, p. e0235091. doi: 10.1371/journal.pone.0235091 https://archive-ouverte.unige.ch/unige:153341

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Deposited on : 2021-07-26

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