Acta Dermato-Venereologica 97-4 | Page 16

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INVESTIGATIVE REPORT
Impairment of Sexual Life in 3,485 Dermatological Outpatients
From a Multicentre Study in 13 European Countries
Francesca SAMPOGNA 1# , Damiano ABENI 1# , Uwe GIELER 2 , Lucia TOMAS-ARAGONES 3 , Lars LIEN 4 , Géraldine TITECA 5 , Gregor
B. E. JEMEC 6 , Laurent MISERY 7 , Csanad SZABO 8 , Dennis LINDER 9 , Andrea W. M. EVERS 10 , Jon Anders HALVORSEN 11 , Flora
BALIEVA 12 , Jacek C. SZEPIETOWSKI 13 , Dmitry V. ROMANOV 14 , Servando E. MARRON 15 , Ilknur K. ALTUNAY 16 , Andrew Y.
FINLAY 17 , Sam S. SALEK 18 , Jörg KUPFER 19 and Florence J. DALGARD 20
1
Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCSS FLMM, Rome, Italy, 2 Department of Dermatology, Justus
Liebig University, Giessen, Germany, 3 Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute, Zaragoza, Spain,
4
Department of Public Health, Hedmark University College, Elverum, Norway, Departments of Dermatology, 5 Notre-Dame de Grâce Clinic,
Gosselies, Belgium, 6 Zealand University Hospital, Roskilde, University of Copenhagen, Copenhagen, Denmark, 7 University Hospital of Brest,
Brest, France, 8 Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary, 9 Section of Biostatistics, University
of Oslo, Oslo, Norway, 10 Department of Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands, Departments
of Dermatology, 11 Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, 12 Stavanger University Hospital,
Stavanger, Norway, 13 Wroclaw Medical University, Wroclaw, Poland, 14 Department of Psychiatry and Psychosomatics, I. M. Sechenov First
Moscow State Medical University, Mental Health Research Center, Moscow, Russia, Departments of Dermatology, 15 Alcaniz Hospital, Alcaniz,
Spain, 16 Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey, 17 Cardiff University School of Medicine, Cardiff, UK, 18 Department of
Pharmacy, Pharmacology and Postgraduate Medicine, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK, 19 Institute
of Medical Psychology, Justus Liebig University, Giessen, Germany, and 20 Department of Dermatology and Venereology, Skåne University
Hospit al, Lund University, Malmö, Sweden
#
These authors contributed equally to the study.
Skin conditions may have a strong impact on patients’
sexual life, and thus influence personal relationships.
Sexual issues are difficult to discuss directly in clini-
cal practice, and a mediated instrument may be useful
to capture such information. In this study item 9 of
the Dermatology Life Quality Index was used to collect
information on sexual impact of several skin condi-
tions in 13 European countries. Among 3,485 patients,
23.1% reported sexual problems. The impairment was
particularly high in patients with hidradenitis suppura-
tiva, prurigo, blistering disorders, psoriasis, urticaria,
eczema, infections of the skin, or pruritus. Sexual im-
pact was strongly associated with depression, anxiety,
and suicidal ideation. It was generally more frequent
in younger patients and was positively correlated with
clinical severity and itch. It is important to address the
issue of sexual well-being in the evaluation of patients
with skin conditions, since it is often linked to anxiety,
depression, and even suicidal ideation.
Key words: skin; quality of life; sexual impairment; hidradenitis
suppurativa; Dermatology Life Quality Index.
Accepted Nov 2, 2016; Epub ahead of print Nov 6, 2016
Acta Derm Venereol 2017; 97: 478–482.
Corr: Francesca Sampogna, Clinical Epidemiology Unit, Istituto Dermo-
patico dell’Immacolata (IDI)-IRCCS FLMM, Via dei Monti di Creta 104,
IT-00167 Roma, Italy. E-mail: [e-mail]
S
exual life is an important component of health-related
quality of life. Skin conditions may have a strong
impact on this component, since they involve appearance,
and thus affect social life and personal relationships. Se-
veral studies have investigated the impact of venereologi-
cal and dermatological diseases with genital localization
on sexual life (1–3). However, regardless of the localiza-
doi: 10.2340/00015555-2561
Acta Derm Venereol 2017; 97: 478–482
tion of the affected body area, the involvement of skin
in a disease may have consequences on intimacy (4, 5).
In clinical practice, it may be challenging for both
the patient and the physician to discuss sensitive issues
directly, so the impact of a disease on sexual life is
rarely assessed. Self-assessment using questionnaires
may provide a viable alternative. Several specific ques-
tionnaires aimed at measuring sexual quality of life are
available (6), and even a single question from a generic
or disease-specific quality of life instrument may yield
some important information.
A relevant issue in the interpretation of studies on
quality of life in general, and of the impact of skin di-
seases on sexual life, derives from the vast cultural and
methodological variations between countries and study
design, as well from the use of different questionnaires.
Therefore, we planned a multicentre European ini-
tiative to provide insight on the impact of skin diseases
on quality of life and psychological wellbeing, using
a single study design with standardized procedures
and common research tools (7). The aim of the present
study was to investigate the perceived impact of several
dermatological conditions on patients’ sexual life, using
item 9 of the Dermatology Life Quality Index (DLQI)
(8), across clinical and demographic variables in 13
European countries.
METHODS
Data presented in this report come from a large, cross-sectional
study on the psychological burden of skin diseases conducted in
13 European countries. The materials and methods were descri-
bed in detail in the main paper (7). In brief, complete data were
collected on 3,635 consecutive, dermatological out-patients, and
1,359 healthy controls. The present report, being focused on the
impact of skin diseases on the patients’ sexual life, is based on data
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Journal Compilation © 2017 Acta Dermato-Venereologica. ISSN 0001-5555