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Traitements psoriasis génital.

Genital Psoriasis: What is the solution?

Discussing diseases that affect intimate areas can always be a complex matter. However, genital psoriasis is a condition that needs to be discussed and understood. What is the appropriate solution for this skin disease?

Testicular psoriasis, vulvar psoriasis, etc.: what's the difference compared to classic psoriasis?

From a scientific perspective, genital psoriasis shares similar characteristics with other forms of psoriasis, but with specific localisations. Indeed, as the name suggests, genital psoriasis is a form of psoriasis that manifests in the private areas. In men, it can occur on the penis, the glans, the testicles, and the groin. In women, psoriasis can affect the pubic area, the labia, the groin, as well as the vulva.

The so-called "classic" psoriasis is characterised by the emergence of red patches and scales that shed over time. This is less the case with genital psoriasis, as this area being more moist, presents fewer scales. The main symptoms of genital psoriasis are:

  • The itching;

  • Skin irritations;

  • The pain caused by micro-lesions.

These symptoms can be mistaken for the signs of sexually transmitted diseases. This further exacerbates the discomfort victims feel in discussing them. If you notice the onset of one or more of these signs, it is imperative to consult a doctor promptly.

Genital psoriasis can be caused by:

  • An inherited genetic predisposition: a naturally sensitive skin that is passed down from generation to generation. About 30% of cases are said to be familial and appear during adolescence.

  • An immune system failure: This is linked to an abnormal presence of white blood cells in the epidermis. These cells produce a high quantity of inflammatory cells and stimulate the proliferation of keratinocytes. Their renewal rate is accelerated, which leads to an accumulation of immature keratinocytes on the skin's surface.

The effects of genital psoriasis on sexual life.

Genital psoriasis can impact the sexual lives of those who suffer from it. A clinical study has gathered the experiences of individuals affected by genital psoriasis. According to their findings, they have less frequent sexual intercourse, a reduced sexual desire, and they avoid sexual relations. These patients experience pain during sexual intercourse and believe that their symptoms worsen after these encounters. Women, in particular, have reported suffering from dyspareunia, a medical term for pain felt during and after sexual intercourse.

Solutions to soothe genital psoriasis.

  • The topical corticosteroids.

    One of the suitable solutions for genital psoriasis is to use a skincare product containing dermocorticoids. Cortisone is one of them. When applied topically, dermocorticoids help to soothe the skin by combating inflammation. They inhibit the NF-kB transcription factor by activating the transcription of the IkB gene, thereby conferring anti-inflammatory effects. Dermocorticoids are available in the form of ointment, lotion, or cream.

  • Coal tar.

    Preparations based on coal tar are often recommended for treating genital psoriasis and this is the second local therapy advised after topical corticosteroids. These preparations can be used as individual therapy or in combination with weak topical corticosteroids. However, despite positive reviews, it has been reported that these treatments can cause irritations.

  • The Vitamin D analogues.

    Vitamin D analogues, such as calcipotriol or calcitriol, are anti-proliferative, meaning they combat the excessive multiplication of certain skin cells, particularly on keratinocytes, by inhibiting the progression from the G1 phase to the S phase. They play a role in regulating cell renewal thereby reducing the formation of thick, scaly plaques characteristic of psoriasis. However, some studies advise against their use for treating genital psoriasis as vitamin D analogues could be too irritating.

  • Immunosuppressants.

    This type of treatment is used when the immune system is not functioning normally. They help to limit the action of the immune system by inhibiting the proliferation of lymphocytes. Pimecrolimus or tacrolimus ointments have often been mentioned.

Note: the use of these treatments helps to alleviate the symptoms of genital psoriasis, but not to cure it. To date, there is still no treatment that can completely cure this skin disease.

Sources

  • MEEUWIS K. A. P. & al. Genital psoriasis: A systematic literature review on this hidden skin disease. Acta Dermato-Venereologica (2011).

  • YANG E. J. & al. The impact of genital psoriasis on quality of life: a systematic review. Psoriasis: Targets and Therapy (2022).

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