Investigation into the effect of body image, self-esteem and distribution pattern of lesions on sexual functioning in Psoriasis patients

Aim: Psoriasis, which is characterised by visible and touchable lesions that can affect any part of the body, may cause sexual dysfunctions. In this study, we aimed to investigate the psychopathology of sexual dysfunctions in psoriasis patients. We aimed to investigate the extent to how body image, self-esteem and sexual functions are affected in psoriasis patients compared to the general population, the effect of lesion pattern on body image, self-esteem and sexual functions, and the relationship between body image, self-esteem and sexual functions. Material and Methods: In this study, 71 female and 89 male patients diagnosed with psoriasis and a control group consisting of 93 female and 90 male healthy volunteers were compared between 01.08.2023 and 01.11.2023. Participants completed the Sociodemographic and Clinical Data Form in the presence of a clinician. After physical examination by a dermatologist, the location of the lesion was determined and Psoriasis Area Severity Index was applied. A structured clinical interview in accordance with SCID-5-CV (Structured Clinical Interview for DSM-5 Disorders, Clinician Version) was conducted. The patient was given the Golombok-Rust Sexual Satisfaction Scale, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale, and Body Image Scale to be completed by the patient. Appropriate statistical analyses were performed and the groups were compared. Results: Psoriasis patients were found to have more anxiety and depression symptoms, and their body image, self-esteem and sexual functions were more negatively affected compared to the general population. Involvement of the genital area in female patients and back and genital area in male patients were found to be associated with low body image, low self-esteem and sexual dysfunction. As the severity of psoriasis increased, body image, self-esteem and sexual functions were negatively affected. It was also found that body perception had a significant effect on sexual dysfunctions and the negative effect of psoriasis severity on sexual dysfunctions was mediated through body perception. Conclusion: As part of a comprehensive approach, the examination of patients with psoriasis should include an assessment of sexual functioning. Screening and improvement of body image and self-esteem concerns should be prioritised, as they may significantly affect sexual functioning. During the physical examination, attention should be paid to the distribution pattern of psoriatic lesions, and patients with lesions in areas at risk for sexual dysfunctions should be evaluated and referred to the psychiatry outpatient clinic when necessary. Keywords: Psoriasis, Body Image, Self-esteem, Sexual Functions