الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a common chronic inflammatory disease of the skin with unpredictable course that affect about 1-3% of the world population. The impact of psoriasis on patient’s quality of life maybe quite destructive for different reasons, so it is important for clinicians to be aware that psoriasis can have substantial emotional effect on an individual, which is necessarily related to the extent of the skin disease. Psoriasis is associated with a variety of psychological problems including poor self-esteem, sexual dysfunction, depression & even suicidal ideation. There are several reports including sexual impact & erectile dysfunction due to methotrexate & etretinate treatment, but there was no similarly comprehensive study about psoriasis and sexual dysfunction. Male erectile dysfunction has been defined as a persistent inability to attain and/or maintain an erection sufficient for sexual performance. It is a very common, and prevalence as well as severity increased with age. It is recognized that a major cause of erectile dysfunction is atherosclerosis affecting the pelvic vasculature .There’s an emerging association between psoriasis and metabolic syndrome and atherosclerotic disease. So, it is hypothesized that erectile dysfunction occur more commonly in patients with psoriasis. The Aim of this study: Assess sexual function, hormonal abnormalities in male patients with psoriasis and to compare with healthy control. Materials and methods: The study was conducted in dermatology outpatient clinic at Mansoura University Hospital over one year duration. A Cross-Sectional Questionnaire-Based study will include (100) sexually active male patients with psoriasis regardless of their age (group A) and (100) normal volunteers (age matched with the patients) who served as a control group (group B). Full history taking, general and systematic examination including several history together with clinical examination to evaluate the extent of the skin disease using psoriasis assessment severity index [PASI] score and evaluation of sexual function using the international index of erectile function [IIEF], which is 15 items, self administered questionnaire scale include erectile function, orgasmic function, sexual desires, inter course satisfaction and overall satisfaction. Each domain is scored on a scale of (0 or 1) to 5. The higher score indicate better function, while the score of zero indicate no sexual activity during the past month. Patients with low sexual function will be assessed by hormonal assay (testosterone, prolactin) using a commercial testosterone and prolactin ELISA Kit for in vitro diagnostic application(Chemux BioScience, Inc-Shinghi, china). Results: Sexual function parameters were significantly lower among patients compared with the controls except libido parameter. Lower levels of testosterone (ng/ml) in patients with psoriasis compared with control persons. While There was no highly statistically significant difference between patients and control groups regarding serum level of prolactin (ng/ml), suggesting a role of hormonal derangement in the pathogenesis of the sexual dysfunction associated with psoriasis. Negative significant correlation between parameters of sexual function and age of patients studied, duration (years), PASI score and serum level of prolactin , while positive significant correlation between parameters of sexual function and serum level of testosterone. Patients receiving systemic therapy showed lower serum testosterone, lower sexual function parameters compared with those receiving topical therapy alone. Conclusion: patients with psoriasis have physical and psychological comorbidities that have been associated with a higher risk of sexual dysfunction. In addition, psoriasis may play a role in its development. The presence of anxiety, depression, psoriatic arthritis, genital lesions, using certain medications and increasing age should raise the awareness of SD. Recommendations: Investigations into sexual health and hormonal assay should be incorporated as routine by clinicians and dermatologists when treating a patient with psoriasis. Comorbidities known to be present in these patients (life style, smoking, cardiovascular diseases, diabetes, obesity and metabolic syndrome) should be evaluated and managed. Furthermore, the dermatologist should be aware that psoriasis treatment could improve or impair the patient’s sexual function.