Q: Can psoriasis affect the genital region? What is the possible cure and precautions? Will it normal sexual activities?

A:The six regions of the genital area that may be affected by psoriasis include:

1. The pubis.
2. The upper thighs next to the groin.
3. The creases between the thigh and the groin.
4. The genitals themselves (the vulva, for women; the penis and scrotum, for men).
5. The skin between the anus and vulva or anus and scrotum, and the skin around the anus.
6. The crease between the buttocks.

• The pubis - The pubis is the region on males and females above the genitals. This area can sometimes be treated similarly to psoriasis on the scalp; however, caution should be taken as skin in the pubic region tends to be more sensitive than the skin on the scalp.
• The upper thighs - Psoriasis of the upper thighs often consists of many small, round patches that are red and scaly. Psoriasis in between the thighs may be more easily irritated if the thighs rub together when you move, walk or run. Wearing shorts beneath clothes or using baby powder can help to decrease the friction between your legs and reduce irritation. The creases between thigh and groin Psoriasis is generally non-scaly and reddish-white in the creases between the thigh and groin. The skin may have fissures (cracks). People who are overweight or athletic may have intertrigo in the skin folds. Intertrigo looks similar to psoriasis, but is a yeast infection in the folds of the skin that is caused by irritation from the friction of skin-on-skin or from clothing.
• The genitals - In men, psoriasis of the penis may appear as many small, red patches on the glans (the tip of the penis) or shaft. The skin may be red and scaly, or it may be smooth and shiny. Genital psoriasis affects both circumcised and uncircumcised males. In women, psoriasis of the vulva often appears as a smooth, nonscaly redness. If this sensitive area is irritated by scratching, it may become infected. Scratching also can produce dryness, thickening and further itching of the skin. Genital psoriasis usually affects the outer skin of the genitals. Mucous membranes, such as the vagina, are not normally affected by psoriasis–however, they can be. In general, genital psoriasis does not affect the urethra, the canal through which urine is expelled from the body.
• The anus and surrounding skin - Psoriasis on or near the anus is red, nonscaly and prone to itchiness. Psoriasis in this area may be confused with yeast, fungal infections, haemorrhoidal itching, strep infections and even pinworm infestations. The presence of these conditions can complicate the treatment of psoriasis, and make the psoriasis worse. Rectal examinations, skin cultures and examinations for pinworm can confirm these conditions so they can be treated appropriately. Symptoms of anal psoriasis may include bleeding, pain during bowel movements, and excessive dryness and itching.
• The buttocks crease - Psoriasis in the buttocks crease may be red and nonscaly, or red with very heavy scales. The skin in this area is not as fragile as that of the groin. In any case, it does not affect sexual activity.