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Sexual dysfunction common in patients with hidradenitis suppurativa

Key clinical point: Sexual dysfunction (SD) and erectile dysfunction (ED) appear to be present in around half of the patients with hidradenitis suppurativa (HS) and negatively affect their quality of life.

Major finding: The prevalence of SD in women with HS ranged from 51% to 62%, and the prevalence of ED in men with HS ranged from 52% to 60%. Potential risk factors for SD were mainly related to disease activity, symptoms, and partners. Mood disorders like depression and anxiety appear to be associated with SD. Women had higher sexual distress than men.

Study details: Systematic review of 11 studies including 42,729 patients with HS.

Disclosures: This study did not receive any funding. Dr. Szepietowski and Dr. Matusiak reported receiving personal fees from multiple pharmaceutical companies, outside the submitted work. The rest of the authors declared no conflicts of interest.

Commentary

“The impact of hidradenitis suppurativa on quality-of-life is significant. It is one of the most distressing conditions systematically studied in dermatology. Sexual dysfunction is a significant contributor to the poor quality-of-life experienced by patients with HS. A number of studies have investigated this relationship in smaller cohorts.

In this systematic review of 11 such studies, including over 40,000 patients, the prevalence of sexual dysfunction (SD) in women and erectile dysfunction (ED) in men ranged from 50-60%. Increased disease activity and symptoms were risk factors for sexual dysfunction which, in turn, correlated with depression and anxiety. As with prior studies, women tended to have greater sexual distress than men.

While those caring for patients with HS will not be surprised by these results, the overall prevalence of SD and ED is shockingly high. While patients and physicians tend to avoid discussing matters of sexual function in routine clinical encounters, the high prevalence and clear significance of this issue as it pertains to quality-of-life, mood disorders, and patient wellbeing, necessitates a comprehensive approach to patient care. Based on these findings, providers should find ways to screen for and discuss sexual dysfunction and mood disorders openly with their patients, connect them with appropriate specialty providers, and offer hope for the possibility of improvement with successful HS management.”

Robert G. Micheletti, MD

Assistant Professor of Dermatology and Medicine

Perelman School of Medicine, University of Pennsylvania

References:
Wolkenstein P, Loundou A, Barrau K, et al. Quality of life impairment in hidradenitis suppurativa: a study of 61 cases. J Am Acad Dermatol. 2007;56(4):621-623.
Kurek A, Peters EM, Chanwangpong A, et al. Profound disturbances of sexual health in patients with acne inversa. J Am Acad Dermatol. 2012;67(3):422-428.

Citation:

E Molinelli et al. Br J Dermatol. 2020 Jun 24. doi: 10.1111/bjd.19337.