What is the relationship between women and psoriasis?

Psoriasis (PSO) is a chronic inflammatory disease with manifestations that include red, scaly, itchy, and/or painful nodules, patches, or papules. These symptoms often mimic the scalp and skin surface dilation but can be widespread in severe cases. Up to 40% of patients with PSO will develop psoriatic arthritis (PsA), usually within 5 to 10 years of the onset of PSO. In addition to PsA, individuals with PSO are also at increased risk of developing a range of comorbidities associated with metabolic syndrome, including hypertension, hyperlipidemia, obesity, and type 2 diabetes.

The popularity of PSO varies around the world; In countries with a predominantly Caucasian population, the prevalence is commonly reported as 1% to 3%. The disease has two modes of onset, with a peak occurring between the ages of 15 and 30 and the second between the ages of 50 and 60. However, > 75% of cases appear before age 40.
Diagnosis of psoriasis in women (mean age: 28 years) and initiation of treatment often overlap with reproductive years (18-45 years), which can pose specific challenges for the treatment. Guidelines for the treatment of psoriasis in women of childbearing age are not currently available, but pharmaceutical company data from the United States and Europe currently summarize safety data regarding pregnancy and lactation. to help make treatment options for this group of patients.
Women with psoriasis can experience fluctuations in disease activity with hormonal changes and with each stage of the journey of motherhood. In a prospective study of 163,763 women (n = 1253 with PSO), menstrual irregularities and surgical menopause were associated with a higher risk of PSO, whereas the trend was in Younger women have a lower risk of PSO than those who have had multiple births and a longer duration of breastfeeding.

Psoriasis in women can have a profoundly negative impact on a patient's quality of life. In a survey of patients with PSO or PsA (n=5604) conducted by the National Psoriasis Foundation (NPF), the majority of patients felt that PSO was a problem in their daily lives. (94%), affecting their overall emotional well-being (88%), and hindering their enjoyment of life (82%). The emotional impact of PSO in critically ill patients (>10% self-reported body surface area [BSA]) compared with mild disease (<3% BSA;).
Women with PSO and PsA show a reduced quality of life in all areas. According to the 2017 World Psoriasis Happiness Report, women with severe PSO had a larger negative impact on their happiness than men, with a corresponding gap of 18.5%. Furthermore, women with PSO were more likely to be stressed (>60%) and lonely (25-28%). Among patients with PsA, women also appeared to have higher scores for disability severity and fatigue.
Women with psoriasis and PSA have a higher risk of depression, anxiety, and suicide. In a study using data objectively collected from the Foundation for Autoimmune Diseases in Pregnancy (OTIS) Project, the prevalence of depression in women with PSO was high. approximately twice that of women without disease (21% vs 12% respectively; p = 0.03).
Psoriasis in women can also lead to impaired sexual ability. Responding to a questionnaire (n = 481), one in four Dutch Psoriasis Society patients reported a decline in sexual activity after disease onset, with women being more affected men (33% vs 19%, respectively; p <. 0001). Approximately half of the women with PSO who responded had sexual dysfunction (n = 88 out of 181 patients; cut-off score of the Female Sexual Function Index: ≤ 26.55). Furthermore, using the Female Sexual Disorder Scale (threshold score: ≥ 15), 38% of women with PSO reported sexual distress. Women with existing genital lesions present significantly more distress than women who are not currently affected (p = 0.001).
In a study of adult patients with PSO (n = 354) in the United States and Ireland, 63% reported having experienced genital PSO at some stage. Among patients with currently active genital PSO, 43% reported a decreased frequency of intercourse. Notably, women experience pain, burning, and discomfort during intercourse more often than men. PsA is also known to interfere with the ability to have physical intercourse, especially when it involves the lower back and sacral joints.
Compared with men, women were more stigmatized as a result of PSO, as assessed by the Stigma Feeling Questionnaire (mean total score 93.2 vs 78.0; p = 0.001) , including questions about predicted rejection, feelings of being flawed, sensitivity to other people's opinions, and secrecy.
Health care professionals (HCPs) can support and reassure patients by initiating discussions around intimacy and dating in an open and honest manner. Guidance on managing PSO in an intimate relationship and how to use makeup and clothing to improve confidence is offered through PSO patient support groups and online (National Psoriasis Foundation). house, 2017). Women with psoriasis may also require assistance in determining what to expect for their therapy; Patients may not always be aware of the optimal achievable condition of their skin, especially if they do not consult a dermatologist who prescribes a full range of treatments. psoriasis in women and PsA, including biologic or systemic agents.

Psoriasis activity levels in women usually improve or stabilize during pregnancy, and a small number of women show a marked improvement in their skin condition. In a study investigating the effect of hormonal fluctuations around pregnancy on PSO (n=47), 55% of women reported improvement and 21% reported no change. In patients with ≥10% improved psoriatic BSA (n = 16; mean BSA: 40%), lesions decreased >80% between the first and third trimesters. However, there is evidence that women with PSO and PsA may also develop more severe skin disease (or highly stable disease) during pregnancy (PSO: ~23%; PsA: ~9%)
Data on pregnancy outcomes for women with psoriasis show mixed results and further studies are warranted. In a 2016 systematic review that included 9 observational studies (6 studies were assessed as good quality), there was no clear evidence of a persistently increased risk of adverse pregnancy outcomes. in women with PSO. Furthermore, a study using data from a nationwide US inpatient sample database (2003-2011; n = 11,204 women with PSO or PsA) found that, after adjusting for As a potential confounder, maternal PSO/PsA did not have a significant impact on inpatient mortality or fetal mortality. The rates of preterm birth, premature rupture of membranes, postpartum haemorrhage, and cesarean section were similar between the PSO/PsA population and the control group.
However, some studies have found a link between disease activity and pregnancy complications or adverse pregnancy outcomes. In a recent cohort study using prospectively collected data from Denmark and Sweden (April 2007 to December 2012; n = 8097 births to PSO/PsA mothers), risk Gestational diabetes, gestational hypertension, preeclampsia, and emergency cesarean delivery have been reported in women with PSO. Lifestyle factors and comorbidities adjusted by the authors included country, maternal and parity age, smoking status, body mass index, depression, diabetes, and hypertension. The risk was higher for women with severe psoriasis, who were also found to have an average risk of preterm birth (32-36 weeks) and low birth weight. The increased risk of low birth weight and preeclampsia in women with severe PSO is consistent with findings from an earlier cohort study evaluating pregnancy outcomes in 1483 pregnant women with PSO. This analysis was adjusted for characteristics of infant (gender and age), mother (age, education level, marital status, income, gestational hypertension, diabetes, deficiency) blood and coronary heart disease) and father (age and education level). Data on pregnancy outcomes in women with PsA are more limited. The cohort study by Broms et al determined the risk of gestational hypertension and preeclampsia in women with PsA (after adjustment for confounding factors as mentioned). Recently presented data from a Swedish cohort (2007-2014) also show an adjusted odds ratio (aOR) for preterm birth of 1.80 (95% confidence interval [CI]). , 1,22-2.64) of 397 PsA pregnancies (n = 289 mothers). However, the rates of preeclampsia, gestational diabetes, and stillbirth were not different between the comparison groups.
In summary, the adverse events associated with rates of preeclampsia, gestational diabetes, and preterm birth among pregnant women with POS are comparable to those in the general population. PSO symptoms tend to decrease in pregnant women with psoriasis.
To minimize the effects that psoriasis in women causes, patients need to go to a reputable hospital to conduct examination and treatment as soon as there are signs of onset. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 level interventional angiography and 1 room for bone mineral density measurement,... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.

References: psoriasis.org, ncbi.nlm.nih.gov