How to treat psoriasis on the genitals. Treatment of psoriasis on the genital organs in men and women. Psoriasis on the genitals

Psoriasis in the intimate area in women is a rather unpleasant phenomenon. Pain, itching, and peeling cause serious discomfort and often disrupt intimate life. The symptoms of psoriasis in the labia area differ from the usual clinical picture and many women confuse this disease with a sexually transmitted infection.

Symptoms

Psoriasis in the labia area is characterized by two types: vulgar and inverse. The clinical picture is significantly different:

1. Vulgar psoriasis. The patient notices the appearance of pink-red rashes with a silvery tint in the groin area. They may peel and cause discomfort. Psoriatic plaques are localized on the labia and pubic area, and can spread to the inner thigh.
2. Inverse psoriasis. The elements of the rash are located in the area of ​​the inguinal folds, where sweating and elevated temperature contribute to the development of weeping. Due to friction and the mechanical impact of clothing, the skin becomes thinner and erosions appear. When the surface of the skin of the labia is damaged, fungal and bacterial infections often occur.

In parallel, other areas of the body can be affected by psoriasis: scalp, armpits, buttocks, lumbar region. In cases where the disease is localized only in the pubic area, many women are not even aware of the nature of the disease, and they turn to a dermatologist in the later stages of the disease.

Causes

Scientists continue to work to determine the causes of psoriasis. It is precisely known about the hereditary nature of the pathology. According to the latest data, the disease can be triggered by:

• bad habits;
• stress;
• overweight;
• immune failures;
• hormonal disorders;
• failure to comply with personal hygiene rules;
• mechanical and chemical damage to skin and mucous membranes.

Many experts say that traumatic brain injuries can also influence the development of the disease. Statistical data confirm that initial visits for psoriasis after traumatic injury to the central nervous system are observed in 12% of cases.

Important! Environmental factors contribute not only to the manifestation of psoriasis, but also to its exacerbations. That is why complex treatment necessarily includes lifestyle correction.

Diagnostics

If suspicious symptoms appear on the labia, a woman should definitely consult a doctor. Visual examination and laboratory tests will help establish an accurate diagnosis. To determine pathology, the following must be carried out:

• general and biochemical blood test;
• scraping of skin scales;
• dermoscopy.

In some cases, consultation with a gynecologist, venereologist, as well as a number of additional tests may be required. Based on the research results, the doctor makes an accurate diagnosis and prescribes appropriate treatment.

Treatment

Treatment of psoriasis on the labia begins with the use of topical products. Ointments and creams are mainly used for treatment:

• hormonal (with corticosteroids);
• antibacterial;
• antifungal;
• healing;
• drying.

Before applying ointments, hygiene procedures for the genitals and groin area are required. Ointments and creams alternate with each other. Hormonal creams perfectly relieve itching and swelling and reduce discomfort. Drying agents reduce weeping and promote healing.

Important! Some medications for external use may cause a local reaction to the drug. Before the course of treatment, it is recommended to conduct a sensitivity test.

To combat concomitant infections when ointments are ineffective, antibacterial and antifungal drugs are prescribed in tablet form. If the lesions are quite extensive and the prescribed treatment does not produce results, the patient is recommended to receive inpatient treatment.

Hygiene of the intimate area is an important part of treatment. Proper care and the use of special cosmetics speed up healing. Herbal decoctions are perfect for washing the groin area. It is recommended to wear loose clothing made from natural fabrics.

Shaving the pubic area in the acute period is strictly prohibited - trauma to the skin aggravates the disease.

A woman may be shy and in a depressed psychological state due to illness. In this case, consultation with a psychotherapist is necessary. Excessive nervousness and emotional distress only aggravate the symptoms.

Intimate life with psoriasis of the labia is not prohibited if the woman does not experience discomfort or unpleasant sensations. Psoriasis is a non-infectious disease and is not sexually transmitted; there is no threat to the partner’s health.

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Psoriasis on the genitals is a fairly common pathology among men and women. The rashes are localized in the groin, abdomen, buttocks, anal area, genitals, etc. They have red and pink shades, a silvery coating and a rounded shape, protruding slightly above the skin. In most cases, patients wait to go to the doctor with their problem until psoriasis develops into a severe form, which leads to complicated treatment.

Causes of psoriatic papules in the intimate area

The exact ones in the intimate area, as well as diseases in general, have not yet been determined by medicine.

However, there are many factors that can trigger the appearance of pathology:

• . This factor is one of the most common. Excessive can lead to the onset of the disease.
• . It is also one of the common causes, in this case the transmission of pathology from relatives is implied.
• , accompanied by disturbed microflora in.
• Serious illnesses suffered in the past.
• Failure of the endocrine system. It is especially observed in females and during menopause.
• Cold or wet climate.
• Allergy to intimate hygiene products.
• Heavy sweating.
• Excessive friction in the groin area. Typical for people who are overweight.
• Failure to comply with personal hygiene rules.
• Wearing underwear of poor quality and made from unnatural materials, rough fabric, tightness.
• Passive lifestyle.
• The influence of drugs.
• Skin injuries.
• Alcohol abuse and other bad habits.

The following specific factors can also lead to inverse psoriasis (damage to skin folds):

• Elevated temperature, which facilitates the penetration of infections and fungi.
• Constant contact of thighs and friction with underwear.
• Insufficient ventilation and humidity in intimate areas.
• Absolute lack of access to sunlight, regardless of the time of year and weather.

Psoriasis is not sexually transmitted.

Symptoms of psoriasis on the genitals

Symptoms of genital psoriasis may differ depending on the gender of the patient. However, there are also common signs, such as itching and irritation of the area where they are located, painful nodules, and redness of the skin.

In men

The characteristic localization of the genital area is the groin area, penis and pubis.

Reddish spots appear on the skin, slightly protruding above the surface and having a clear outline.

As a rule, they are covered with a pearlescent scaly layer.

Often this type of psoriasis is also accompanied by damage to other parts of the body, such as limbs, abdomen, back, etc.

Among women

Intimate affects the pubis, labia majora and minora, mucous membranes of the vagina, space, and groin. Often papules also appear under the breasts and in the armpits. The elements of the rash have a pinkish tint, a chaotic order and are covered with whitish scales. The symptoms are very similar to those of vulvitis.

Often this pathology begins to develop in adolescence and worsens during lactation and pregnancy, menopause, due to various hormonal surges.

Stages of the disease

Genital psoriasis, like other types of pathology, occurs in three stages:

1. Progression. The number of psoriatic manifestations is growing at a fairly rapid rate, affecting various areas of the skin, and pre-existing plaques are increasing.
2. Stationary stage. The growth of the rash stops, the disease is stable.
3. Regression. During this period, peeling decreases, rashes lose color or become more saturated.

Psoriasis of the genital organs is characterized by exacerbation in cold seasons, and it occurs cyclically. With proper treatment, a long period of remission is possible.

Complications and consequences of the disease on female and male genitalia

Genital psoriasis is considered a severe form of the pathology. But if symptoms are ignored, self-medication and delays in going to the doctor, the patient worsens his situation.

If the patient is not treated properly for a long time, the psoriatic papules may begin to coalesce, eventually forming a large affected area accompanied by severe pain.

First of all, the manifestations of this disease significantly worsen the quality of sexual life. Against the background of itching, libido decreases; the emotional state can also be affected by the very presence of rashes.

Sometimes the disease can even affect the skeletal system. In addition, the presence of pathology increases the risk of diabetes, stroke or coronary heart disease.

Despite the fact that genital psoriasis does not affect the reproductive function of both sexes, during its treatment hormonal medications may be prescribed, which can disrupt the normal course of pregnancy and cause miscarriage.

Which doctor should I contact?

When a rash is discovered on the genitals, they are often in no hurry to go to the hospital, but the sooner treatment is started, the easier it will be and the lower the risk of complications.

At the first signs of genital psoriasis, you should contact a dermatovenerologist. If necessary, other doctors (gynecologist, immunologist, urologist, endocrinologist) will be involved in the therapy.

Diagnostic methods

Psoriatic manifestations can be confused with symptoms of other diseases.

To determine an accurate diagnosis, the following steps will be required:

• Medical examination, collection of anamnesis of the disease.
• Study of genetic predisposition.
• Laboratory blood tests.
• Additional measures in the form of a biopsy of the affected areas of the skin or dermoscopic analysis.

How to treat genital psoriasis

The principle of treatment for genital psoriasis is the same for men and women. If the pathology occurs in a mild form, it is sufficient to use external agents - ointments, gels and creams. In severe cases, therapy is supplemented with oral medications.

In the progressive stage, intimate psoriasis can spread to the perianal area, which will provoke a number of complications, such as hemorrhoids, inflammation of the mucous membrane, and helminthic infestations. Accordingly, such factors complicate treatment.

Also, therapy is usually supplemented with sedatives and hypnotics, since the basic step in the fight against any type of psoriasis is the elimination of stressful conditions that aggravate the course of the disease.

How to apply psoriatic rashes in the groin area

For external use, the doctor prescribes drugs belonging to the following groups:

• Drying agents (Fluorocort, Skip-Cap).
• Hormonal (Silcaren, Ultralan, Diprospan, Avecort, Flucinar).
• Healing (herbal-based herbal remedies).
• Moisturizers (baby cream, Mustela, Vichy).

As a rule, prescribed ointments and creams are alternated, as they have different properties. Thus, hormonal agents help cope with swelling, severe itching and redness.

They can be applied to the skin and mucous membranes. However, such drugs cannot be used for a long time, because tolerance and addiction may occur.

Healing agents are applied after drying ones after some time. The latter eliminate the weeping of the affected areas and allow them to heal. The former accelerate tissue regeneration.

Moisturizing creams and ointments are used only in the case of vulgar psoriasis; they do not allow the skin to crack.

The affected skin should be smeared several times a day; before each application of the product, the patient should take a shower.

What medications to take

Oral medications are used only if external agents do not provide the required effect or it is completely absent. However, local therapy is not suspended, but is combined with tablet medications.

Psoriasis on the head of the penis, groin, perineum, vagina, etc. in severe form is treated with the following means:

• Prednisolone.
• Methotrexate.
• Psorkutan.
• Cyclosporine.
• Metipred.
• Daivonex.

If a secondary infection is associated with psoriasis, antifungal agents, antibiotics and sedatives (Persen, Afobazol) are added to therapy.

Treatment with folk remedies

They will be an excellent addition to the complex treatment of intimate psoriasis.

The most common recipes are:

• Ointment based on Vaseline and celandine powder. Mix the ingredients in equal proportions and apply a thin layer to the affected areas once or twice a day.
• Bath with copper sulfate. Place three tablespoons of the substance in prepared water and lie in it for 15 minutes.
• Ointment made from propolis and butter. Melt 200 grams of the second ingredient in a steam bath or in the microwave, mix with 10 grams of the first. Cool and rub into affected skin.
• Salt bath. You need to add 700 grams of sea or regular salt to the prepared water.
• Sugar-potato powder. Mix powdered sugar and potato starch in equal proportions and apply to dry and clean skin.
• Bath based on medicinal herbs. You should take a tablespoon of the following plants: wheatgrass, string, motherwort, celandine, chamomile, calendula. Pour boiling water over the mixture and let it sit for a while, then pour it into the bath.
• Lotions. Take fresh burdock root, flax seed, grape leaves and milk, mix everything. Soak a sterile cotton pad in the mixture and apply to the rash.
• Chop celery root and apply to affected areas to relieve itching.
• Make a paste from Kalanchoe and apply to plaques.
• Infusion from plants. Mix one and a half tablespoons of soapwort root with a tablespoon of burdock root, pour boiling water over it and simmer for 10 minutes. Cool and take throughout the day.

Prevention of disease in the groin area

Prevention measures will help both avoid the appearance of genital psoriasis and delay relapse. Doctors recommend following these rules:

• Give up bad habits, namely smoking and alcohol.
• Maintain healthy sleep.
• Choose loose clothing made from natural materials to wear.
• Take walks in the fresh air more often.
• Adjust your diet. Limit fried, spicy, fatty foods, sweets and caffeinated drinks.
• Do not wear tight or chafing underwear.
• If you have a disease, avoid epilation of the bikini area; if you do not, reduce it to a minimum.

Genital psoriasis is a non-infectious disease that cannot be cured forever. It appears as pink or red papules, the affected areas are covered with scales and have a silvery color. As the plaques progress, they grow and can form quite large lesions, which will be accompanied by itching and pain. To make the treatment as easy and effective as possible, you should contact a dermatovenerologist at the first symptoms of the pathology.

Skin changes in psoriasis can be localized on any part of the body. Psoriatic lesions on the limbs, torso, and head cause a lot of suffering, but psoriasis in the groin is even more unpleasant; this form of the disease can affect both men and women. Damage to the perineum leads to constant discomfort and negatively affects personal life. Psoriasis in intimate areas should be treated as early as possible, but always under the supervision of a dermatologist, since not all antipsoriatic drugs can be used to treat sensitive skin.

Causes of psoriatic lesions in the groin

The reasons for the development of any form of psoriasis are almost identical. The disease may be a consequence of:

• Genetic predisposition;
• Reduced functioning of the immune system;
• Hormone imbalance;
• Severe chronic diseases;
• Prolonged stress.

Naturally, the likelihood of a disease occurring increases many times over if the human body is affected by several factors predisposing to pathology.

The appearance of psoriasis in intimate places is also explained by the characteristics of this area of ​​the body. Predisposes to the appearance of psoriatic lesions in the perineum:

• Increased skin moisture in this area;
• Mechanical friction of clothing, especially from elastic bands and seams;
• Lack of sufficient air access due to wearing synthetic underwear;
• Insufficient hygiene of the intimate area;
• Microtraumas that appear after hair removal;
• Obesity. Psoriasis in the groin most often appears in obese people in the area of ​​fat folds in the perineum.

Psoriatic lesions in intimate areas are most often combined with rashes on other parts of the body. Skin changes can spread to the perineal area from the upper thighs, buttocks, and lower abdomen.

Inguinal localization of psoriasis leads not only to physical discomfort, but also becomes the cause of psychological problems. Psoriatic lesions in this area tend to spread quickly, and periods of remission can quickly be replaced by another exacerbation of symptoms. The thing is that in this place of the body there are all the suitable conditions for the formation of rashes - thin and sensitive skin, high humidity and heat. Therefore, if even minor signs of dermatitis appear in the intimate area, you should consult a doctor as soon as possible - timely treatment begins to prevent the progression of changes.

Symptoms of inguinal psoriasis

The disease begins with the formation of small raised spots above the skin; when localized in the groin, they have the following characteristics:

1. Pinkish, less often red or bluish tint;
2. Diameter from 3 to 20-25 mm;
3. Red rim along the border of a separate lesion;
4. Grayish coating on the surface;
5. Soreness and slight swelling in the area of ​​the rash.

Foci of psoriasis on the pubis and perineum most often either do not itch at all, or the itching is not too intense or periodic. Peeling is also not typical for rashes in these places, which is associated with the constant humidity of the intimate area. As the disease progresses, individual lesions merge with each other, resulting in the appearance of a large spot.

Psoriasis in the perineum occurs equally often in both men and women, and generally the first symptoms of the pathology appear after 25 years.

Features of psoriasis of the groin area in men

Psoriasis in the groin in men can include:

1. glans penis;
2. Testicles;
3. Pubic area;
4. Intergluteal fold and area around the anus.

Inguinal psoriasis can be accompanied by the appearance of reddish impurities in the semen; often with this form of the disease, the quality of sexual life also deteriorates. When lesions are located on the penis, there is a risk of inflammation of the foreskin of the penis - balanoposthitis.

Features of intimate psoriasis in women

Psoriasis in the groin in women covers:

• Labia minora and labia majora;
• Skin around the anus and buttocks;
• Pubis and bikini line area;
• Inner walls of the vagina.

The intimate form of psoriasis also includes psoriatic lesions located under the breasts and in the armpits. Lack of timely treatment for lesions of the labia and vagina becomes the cause of vaginitis.

Exacerbation of inguinal psoriasis in women most often occurs during periods of hormonal imbalance. That is, during pregnancy, during the postpartum period, during menopause and with some gynecological diseases.

If changes appear in the perineum, you should consult a dermatologist. Psoriasis in the intimate area can occur with atypical symptoms, so the disease can be confused with other dermatoses. A thorough examination helps to make a correct diagnosis:

• Examination of the patient’s body – inguinal psoriasis often accompanies psoriatic plaques on other parts of the body;
• Questioning - the doctor must determine when the first symptoms appeared, what, in the patient’s opinion, provoked them, whether plaques appeared in the past;
• Take a scraping from the stains and conduct a microscopic examination of it;
• Dermoscopy;
• Blood tests.

Additionally, a consultation with a urologist may be required for men, and an examination by a gynecologist for women.

The task is to correctly determine the cause of dermatosis and, when psoriasis is diagnosed, to prescribe specific therapy.

Principles of treatment

Your doctor should tell you how to treat psoriasis in the groin. Not all external preparations are suitable for treating skin in the intimate area; this must be taken into account when choosing them. Treatment should be comprehensive, including external medications, physiotherapy, and folk remedies.

Drug therapy

Treatment always begins with the use of ointments to treat the plaques. At the early stage of the disease, non-hormonal agents, such as:

1. Salicylic ointment;
2. Tar-based preparations;
3. Ointments with zinc.

Under the influence of the above mentioned remedies, inflammation is reduced, itching, flaking and pain are reduced, and the spots are prevented from increasing in size.

If non-hormonal therapy does not lead to the desired results or the disease immediately manifests itself in a severe form, then the plaques should be treated with hormone-based ointments, such as:

1. Elokom;
2. Daivonex;

Ointments with glucocorticosteroids have a rapid therapeutic effect. Under their influence, inflammation decreases in a few days, swelling and itching disappear, and all dead skin is removed. However, only a doctor should prescribe hormonal drugs, as they can lead to extremely undesirable side reactions if used incorrectly.

The basic rule for using ointments with hormones is to comply with the duration of the course and the frequency of application of the drug. It is undesirable to use these drugs if psoriasis in the groin manifests itself easily, since they can become addictive to the body and further treatment will be successful only with the use of stronger, but at the same time toxic, medications.

In addition to external remedies for psoriasis, the use of vitamin complexes, in some cases, immunomodulators and agents that improve metabolic processes is indicated. The complete regimen of drug therapy also depends on whether the patient has chronic diseases - if they develop, appropriate therapy is necessary.

For psoriasis in the groin, antimycotic drugs are often prescribed; their use prevents the development of fungus and prevents the addition of a secondary infection.

Traditional methods of treatment

You can supplement the main therapy with all kinds of herbal remedies; they are used both internally and externally for psoriasis. Traditional therapy enhances the effect, improves local and general immunity, and promotes skin regeneration. The following methods of treating psoriasis in the groin show good effectiveness:

• Oak bark decoction. One hundred grams of crushed oak bark should be poured with a liter of hot water, heated over low heat for 20 minutes, cooled and strained. The prepared decoction is used to wipe psoriatic plaques 2-3 times a day, it dries the skin well, removes inflammation and itching;
• Aloe pulp. Peel the fleshy aloe leaf and apply it to the stain area, securing it on top with a band-aid. The compress can be left overnight. If psoriasis covers the areas near the anus or between the buttocks, then you need to prepare a paste from the pulp of the agave, apply it to a tampon and apply it to the plaque also overnight;
• Treating leather with oil – linseed, olive, almond. Oil is especially useful for lubricating cracked skin. Before processing, the oil is brought to a warm state in a water bath;
• Tincture of elecampane. You will need 250 grams of elecampane rhizomes, they need to be washed, crushed and filled with vodka in a volume of 0.5 liters. The product should infuse for about 2 weeks, after which it is used to wipe psoriatic lesions;
• Baths with medicinal herbs. To prepare an infusion for the bath, you need to take 2-3 tablespoons of herbs (chamomile flowers, sage, calendula inflorescences) and brew with a liter of water. After 40-50 minutes, the infusion is filtered and poured into a bath with 5-7 liters of warm water. You need to sit in such a bath for 20-30 minutes; it effectively removes irritation and itching from the genitals with psoriasis in the groin, and promotes skin healing.

To achieve visible results, folk remedies should be used for a long time, sometimes for months. Short breaks should be taken between courses of treatment. External treatment can be supplemented with internal treatment. For psoriasis, infusions and decoctions of soothing herbs, teas that normalize metabolic processes and enhance the functioning of the immune system are useful.

Extra in the groin

If psoriasis occurs in the perineum, several recommendations should be followed:

1. Wash yourself at least twice a day, and each time after bowel movements. In this case, you need to use hypoallergenic soap, for example, fragrance-free baby soap. After washing, dry the genitals with a soft towel;
2. Try not to overheat the perineal area;
3. Wear underwear only from natural fabrics;
4. To wash, you can use a decoction of chamomile, nettle, mint leaves; they relieve itching and irritation;
5. You definitely need to reconsider your diet. It is necessary to exclude allergenic foods, smoked foods, fatty foods, sweets, soda, and alcohol from the diet;
6. Try not to scratch psoriatic lesions. If severe itching occurs, you can take antihistamines in the acute phase of the disease;
7. It is advisable for obese patients to lose weight, since psoriasis in the groin can be localized specifically in the area of ​​fat folds.

The treatment prescribed by the doctor must be completed completely. A decrease in the severity of plaques in the intimate area does not indicate that the progression of the disease has been stopped. If therapy is interrupted at this stage, then the symptoms are more likely to return again and most likely they will be more pronounced.

Psoriasis in the groin causes a lot of discomfort. Unfortunately, it is impossible to completely defeat the disease, since it is a chronic pathology. But with timely therapy and compliance with all stages of treatment, it is possible to achieve periods of remission that will last up to several years.

The epidemiology of lichen planus has been well studied. The pathology is very common; 2-4% of the world's population suffers from psoriatic rashes. In developed countries, especially with cold climates, the incidence rate is higher; the indigenous people of South America do not know this disease at all. The likelihood of getting the disease is approximately the same in men and women, but the course of the disease in men is usually more severe. In approximately a quarter of cases of psoriasis, the disease developed after damage to the epithelium. The provoking factor in the onset of the disease or its relapse in 45% of patients was a bacterial infection, in particular pharyngitis.

Hereditary predisposition to psoriasis is the most serious risk factor. If one of the parents has psoriasis, the risk of the child getting the disease is 14-25%; for both, the risk more than doubles. The probability of developing the disease in a child of healthy parents is 12%.

Currently, two types of psoriasis are classified:

• the first type (early) is hereditary, it affects females on average at 16 years of age, males at 22 years of age, the course is severe, associated with histocompatibility antigens, at risk are individuals with the HLA-Cw6 phenotype;
• the second type (late) – isolated cases of the disease not associated with histocompatibility antigens; begins at about 60 years of age, the course is relatively mild, but in these cases the nails and joints are often affected.

Males are susceptible to genital psoriasis more often than women. The disease usually develops in the age range from 25 to 50 years, at risk are people living in climatic zones characterized primarily by low temperature and high humidity.

Causes of genital psoriasis

There are several hypotheses about the etiology of this disease in general, and none of them is fully recognized, but in almost all assumptions the leading role is given to heredity. This is evidenced by the fact that in the family history of people suffering from psoriasis, this pathology occurs much more often than in the population as a whole.

The question of the type of inheritance of the disease still remains open, but most data indicate the leading role of genetic factors in the pathogenesis of the disease. Whether it is a viral theory that explains the causes of the disease by retroviruses, inherited genetically, or an autoimmune one. In any case, psoriatic skin lesions in individuals with a genetic predisposition occur mainly in the presence of external or internal factors that weaken the immune system.

Risk factors

Risk factors that activate rashes on the genitals:

• the presence of papules and plaques on other parts of the body;
• heredity;
• hormonal fluctuations (puberty, pregnancy, menopause, hormonal therapy);
• diseases of the genitourinary system;
• overexertion and stress;
• the presence of chronic infectious diseases (tonsillitis, caries);
• traumatic disorders of the epidermis in the intimate area;
• severe freezing or prolonged exposure to low temperatures, especially in a damp room;
• vaccination, taking medications (psychotropic, cytostatics, immunomodulators, NSAIDs), drug allergies;
• food allergies, food and alcohol intoxication;
• radical change in climatic conditions;
• chronic diseases: endocrine, neuropsychiatric, autoimmune, etc.;
• excess weight.

Psoriasis is a non-infectious disease and it is impossible to become infected through sexual contact; even with a blood transfusion from a sick person to a healthy person, psoriasis is not transmitted, which seriously contradicts the viral theory of the occurrence of the disease.

Pathogenesis

The pathogenesis of psoriasis, as well as its root cause, remains an open question today. It has now been precisely established that in the pathogenesis of this disease, the inherited immune response of peptide information molecules (cytokines), leading to changes in skin keratinocytes, is of greatest importance.

Genital psoriasis is not a separate disease, but just a localization of rashes, and in most cases it is not the only one on the body. Lichen squamosus can affect any part of the body, but there are areas of skin on the body from which the rashes practically do not go away. In the vast majority of patients, these are the elbows and knees (98% of cases), chest and abdomen (96%), back and buttocks (95%). The scalp is affected somewhat less frequently (78% of cases of the disease); rashes on the facial skin occur in every second case. Rashes on the genitals are not a common location.

Symptoms of genital psoriasis

Typical first signs of the disease in any localization are the appearance of deep pink or red papules covered with loose silver-gray scales.

Genital psoriasis in women is often associated with hormonal surges or deficiency: puberty, pregnancy, menopause. Rashes are found on the pubis, the skin of the labia majora, in the inguinal folds and, in some cases, the mucous membranes of the labia minora are affected. As a rule, women, even those with psoriatic plaques in other locations, mistake them for some disease, gynecological or infectious.

Psoriasis on the labia has a rather specific appearance - these are small reddish papules, clearly defined, shaped like a circle (oval), covered with silver-gray scales. They usually don't itch.

Genital psoriasis in men is localized on the penis, inguinal folds and on the pubic skin. The rashes look like pinkish-red papules with a clear border, slightly raised above the surrounding surface, covered with silver-gray scales. They usually do not itch or flake. In some cases, psoriasis on the penis can spread to the inner surface of the prepuce. In men, as in women, psoriatic plaques of other locations can almost always be found on the body.

An atypical form of this disease, inverse (reverse) psoriasis, is often severe. In the natural folds of the skin of the groin area, shiny, moist and smooth spots of bright red color are found, devoid of specific silver-gray scales. These areas of the body are regularly subjected to mechanical friction, which irritates the skin, it begins to itch, the surface cracks, ulcerates, which can lead to infection.

Stages

The course of genital psoriasis, like any other localization, is sinusoidal - a period of remission is replaced by exacerbation, which is divided into the following stages:

• progressive - at this time, new primary papules regularly appear, and existing plaques increase;
• stationary, when the formation of new formations stops and they become covered with scales, and old plaques stop growing (with the inverse form, scales do not appear, the growth of spots simply stops);
• regressive, characterized by the disappearance of symptoms, oriented from the center of the spots to their periphery.

The most common types of psoriasis on the genitals are vulgar and inversive.

Complications and consequences

The consequences and complications of a late visit to the doctor with the problem of genital psoriasis can be very serious. If in the initial stage remission is usually achieved using external treatments, then later more serious therapy is used. In addition, as a result of the addition of a bacterial or fungal infection, suppuration, swelling, and erythema can be detected, which significantly complicates both diagnosis and treatment.

Genital psoriasis interferes with normal, regular sexual life, and patients often experience neuropsychiatric disorders. In men, penile psoriasis can be complicated by inflammation of the inner layer of the foreskin (balanposthitis), in women – by vaginitis.

The most common complications are exacerbations of clinical manifestations of the disease. Upon examination, psoriatic erythroderma, pustular rashes, and, in the worst case scenario, joint damage are discovered.

Diagnosis of genital psoriasis

To establish the cause of the rash, a visual examination and a detailed interview of the patient is carried out. The doctor finds out whether the patient has chronic diseases, what events preceded the development of the disease, whether close relatives had similar pathologies, determines the necessary laboratory tests and additional examinations.

In the initial forms of the disease, blood tests are usually within normal limits.

In cases of an atypical form of psoriasis in the intimate area, a biopsy of the affected areas of the skin and its microscopic examination are prescribed to clarify the diagnosis. In addition, you can usually find manifestations of the disease in other natural folds - axillary, buttock.

Dermatoscopy may be prescribed - instrumental diagnostics used for skin pathologies.

Additional examinations are carried out at the initiative of the attending physician to determine the condition of the internal organs and concomitant diseases, as this may affect the choice of treatment methods (electrocardiography, ultrasound of the thyroid gland, abdominal organs, radiography).

Differential diagnosis

Differential diagnosis of rashes on the genitals is carried out after collecting anamnesis, tests and the results of additional studies in order to avoid misdiagnosis and distinguish it from pathologies with similar clinical manifestations. It is necessary to exclude the presence of:

• Reiter's disease;
• fungal skin infections;
• vulvitis;
• balanposthitis;
• cutaneous T-cell lymphoma;
• inguinal erythroderma and other skin pathologies, since the addition of an infection can significantly blur the clinical picture of the disease.

Treatment of genital psoriasis

Genital psoriasis is treated, basically, in the same way as psoriasis of other localizations. Complex therapy is more often used: local, systemic and physiotherapeutic procedures, however, in mild forms monotherapy is used with external agents or, for example, phototherapy. Antipsoriatic drugs are usually prescribed in combination with antibacterial or antifungal agents to prevent infection.

When prescribing treatment, the doctor takes into account the stage of the disease (progressive, stationary, regressive), type and prevalence, age of the patient and concomitant pathologies. For therapy to be effective, patients must adhere to dietary and skin care recommendations. Avoid alcoholic drinks, spicy and fatty foods, and limit easily digestible carbohydrates. It is recommended to eat vegetable dishes, dairy products, fish and seafood, dietary meat, fresh fruits, berries and vegetables. Patients, especially in the progressive stage, should not expose the epithelium to mechanical stress (scratching, rubbing); procedures that irritate the skin surface are excluded.

In modern dermatology, they try to use cytostatics and glucocorticosteroids to a minimum, taking into account the serious side effects of their use. However, to relieve the manifest manifestations of the disease, a complex hormonal medicine is used Diprospan(betamethasone dipropate and disodium phosphate). It significantly reduces allergic and inflammatory manifestations and normalizes the action of the immune system. It has a weak mineralocorticoid effect, but with short-term use of the drug it can be neglected. Betamazone disodium phosphate ensures the rapid action of the drug. It is administered intramuscularly, dosing 1-2 ml. Injections are given once a week in short courses. A single injection or a short period of administration of the drug, the purpose of which is to relieve an acute condition, allows you to avoid serious side effects from the nervous system, psyche, and digestive organs, which are possible with long-term use or overdose. Diprospan is not for use by pregnant and lactating women.

Can be assigned Neotigazon– a synthetic retinoid, effective in severe cases of the disease. The active ingredient is acetritin, which inhibits the processes of cell division, growth and keratinization, stabilizes cell membranes, and normalizes the protective properties of the epidermis. Treatment begins with daily dosages of 25, 30, 50 mg (according to the severity, course and effectiveness). They are taken for up to one month, then reduced to maintenance, determined individually. The course of maintenance therapy is up to two months. If the disease persists, the drug can be combined with other methods of therapy: external, physical therapy. Women of fertile age during a course of retinoids should be effectively protected from conception.

An immunosuppressant is used quite successfully in the treatment of forms of psoriasis that are difficult to treat. Sandimmune Neoral(the active ingredient is cyclosporin A, a cyclic polypeptide consisting of 11 amino acids). Inhibits the activity of T-lymphocytes, the development of antibody production dependent on them and reducing their sensitization to antigens, blocking the growth factor of T-lymphocytes. Side effects depend on the dose and are reversible when the drug is discontinued, the most common being renal failure and hypertension. Duration of treatment is 2-3 months, maintenance therapy is up to one and a half months. During treatment, it is necessary to monitor serum creatinine levels and blood pressure.

The choice of local medications is considerable; depending on the type and severity of the rash, you can choose different remedies - from simple non-hormonal ointments to corticosteroids. Dosage forms - gels, lotions, solutions are not used when treating mucous membranes, as they contain ethyl alcohol. However, these forms prevent the greenhouse effect from occurring in inverse psoriasis, which is localized in the folds of the skin.

Hormonal ointments are known for their speed of action, and the systemic effect of local drugs is insignificant. Typically, an exacerbation is relieved by a short course of steroids, and residual effects are eliminated with ointments that do not contain hormones.

Currently, complex preparations containing a hormonal active ingredient in combination with salicylic acid or an antibiotic are most often prescribed. For example, ointment Diprosalik– a combination of betamethasone dipropionate, a highly effective glucocorticosteroid that relieves inflammation, allergies and itching in a short time, and salicylic acid, which has exfoliating, antiseptic and reparative properties, and also conducts the hormonal component into the deeper layers of the epidermis. The ointment is applied twice a day, lightly rubbing. When prescribing maintenance therapy, the frequency of application is reduced. The duration of treatment is prescribed by the doctor individually. Contraindicated in cases of sensitization to components, tuberculosis and fungal infections.

Belosalik ointment contains similar active ingredients.

In combination with salicylic acid, ointment Elokom S (hormonal component - mometasone furoate), Lorinden A (flumethasone pivalate) is produced.

Relatively recently, a combination ointment appeared Daivobet, containing a synthetic derivative of vitamin D - calcipotriol monohydrate and an effective corticosteroid - betamethasone dipropionate. Their combination actively reduces the symptoms of psoriasis. Calcpotriol increases the absorption of the hormonal ingredient, which contributes to a more pronounced anti-inflammatory and antiallergic effect. This component also slows down the processes of division and growth of keratinocytes, normalizing the proliferation of epidermal cells. Experts note that the use of this ointment does not cause side effects and leads to stable remission.

You can use non-hormonal external agents - Daivonex ointment, a single drug with the active component calcipotriol. It has a pronounced exfoliating effect, quickly removing scaly skin, itching and normalizing the proliferation of keratinocytes.

Creams and ointments based on grease with plant and mineral components and natural beekeeping products are produced: Akrustal, Kartalin, Cytopsor, Magnipsor, Antipsor, Solipsor, the manufacturers of which promise a quick effect and long-term remission.

Almost all vitamins are used in the treatment of scaly lichen. For example, the vitamin complex Decamevit or Essentiale simultaneously with injections of fat-soluble vitamins A (daily dosage 50-60 thousand units), D3 (10-15 thousand units), E (200 mg). The duration of treatment is 4-6 weeks at intervals from four to eight weeks.

Sometimes vitamin D3 is prescribed in combination with calcium gluconate (500 mg three times a day) for a month with mandatory regular checks of calcium levels in the blood.

Physiotherapeutic treatment is widely used to eliminate psoriatic rashes. In particular, photochemotherapy, with photosensitizing agents: Puvalen, Beroxan, Psoralen or with a synthetic flavored analogue of retinoic acid (tigazon). The affected skin is irradiated with long ultraviolet waves using a special PUVA unit. The medications are prescribed on the day of irradiation. If you are intolerant to photocoumarins or tigazone, PUVA therapy without the use of drugs is prescribed. Presumably, the effect of ultraviolet irradiation is due to the fact that with the help of the procedure, representatives of antigens - Langerhans cells that interact with T-helpers - are eliminated from the skin, and those that interact with T-suppressors remain. The improvement in the condition is caused by the predominance of the suppressor effect over the helper effect, which prevailed before PUVA therapy. Also, ultraviolet irradiation inhibits the process of production of nuclear DNA in keratinocytes, which reduces their proliferation.

Procedures with photocoumarin applied to the skin or baths with its solution are also practiced.

For psoriasis, the following are also prescribed: laser irradiation of the blood; balneotherapy; magnetic therapy; electrophoresis using glucocorticosteroids; phonophoresis.

Genital psoriasis can be complicated in men by inflammation of the penis (balanitis or balanposthitis). complicated by phimosis - the inability to expose the head of the penis. With progressive phimosis and ineffectiveness of therapy, surgical treatment is performed - excision of the foreskin (circumization).

Alternative Treatment

Psoriasis is a serious chronic disease that is incurable to this day. Psoriatic rashes on the genitals are no exception to this rule. Attempts to cope with the manifestations of the disease on your own are fraught with dire consequences. However, there are many tips on how to alleviate the condition during an exacerbation without leaving home. You just need to take into account that folk remedies do not always interact positively with medical prescriptions, therefore their practical use is advisable only after discussing the beneficial effect with the attending physician.

Traditional treatment To prolong the latent period and alleviate the condition of the skin during exacerbations, he recommends home “balneotherapy”:

• Therapeutic sea baths.

They are prepared in the following proportions: 250-500 g of sea salt are dissolved in 50 liters of water. First, salt is added to hot water so that it dissolves better, then, mixed with cold water, brought to the required temperature (≈34-37 ° C) and volume. Sea baths for medicinal purposes are taken for no less than 15, but no more than 25 minutes at a time, with an interval of one day.

• Therapeutic baths with the addition of infusions of medicinal herbs: soapwort, string, celandine, St. John's wort, valerian root or sage.

Procedures can be done every other day or daily. Herbal infusion is prepared from any of the listed herbs in this way: measure out four tablespoons of crushed herbal raw materials and brew with a liter of boiling water. Let it brew for at least six hours. Prepare a bath with water temperature of 37-38°C, strain, pour the infusion into it. The duration of the bath is no more than a third of an hour.

A course of home balneotherapy requires from 15 to 20 baths. After leaving the bath, do not dry yourself, but only lightly dry your skin with a towel.

Herbal treatment occupies the main place in home folk medicine. When treating skin diseases, dandelion is recommended; you can eat fresh flowers, stems and roots of this plant, make salads from them, dry them and make jam. Dandelion cleanses the blood and liver well, removing toxins, which is important for such a complex multifactorial disease as psoriasis.

Dandelion oil in folk medicine is positioned as a universal medicine. For skin diseases, especially dry lesions of the epithelium, apply natural linen or cotton cloth soaked in oil to areas with rashes. This product can be prepared as follows: in the morning, collect the above-ground part of flowering plants on a fine sunny day (it is advisable that the forecast for the month is also without rain), grind until the juice is released and fill ½ glass jars with the mixture, adding any vegetable oil to the top. Tie the neck of the jar with gauze and place it in a sunny place, leave for three weeks. After this period, squeeze and filter. Place for storage in a dark place, but not in the refrigerator.

For skin diseases, use a mixture of dry crushed dandelion roots and burdock leaves. Mix a tablespoon of raw materials from each plant. This mixture is soaked in three glasses of water for at least eight hours. Boil for ten minutes. Allow to cool and strain. Use five times a day simultaneously internally (½ cup) and externally (lubricating the affected areas).

You can make a paste of fresh dandelions and spread it on psoriatic scabs or squeeze the juice onto the scabs. It’s also a good idea to make lotions with thistle juice. However, these procedures are only feasible in the summer, while there are fresh plants, preferably flowering ones. Plants need to be picked in ecologically clean places, the distance from which to busy highways is at least 1.5 km.

Purslane seeds are very effective in treating psoriatic rashes. After treatment with this herb, a long-term remission is promised. Preparing the infusion is very simple: two tablespoons of the seed are steamed for an hour in a thermos. Strain, cool slightly and apply lotions to the rash, wetting the cloth during the procedure so that the affected areas are abundantly moistened. The infusion is prepared fresh every time. In 2-2.5 months of daily procedures, the skin is completely cleansed and the latent period is promised from three to five years. Purslane seeds are usually not sold in pharmacies, but they can be purchased in online stores; you need to order the “Purslane Vegetable Seeds” collection. Five or six packs are usually sufficient for a course of therapy.

You can prepare an ointment from a thick string extract based on lanolin and petroleum jelly (1:1:1) and lubricate the affected skin with it.

The string extract is taken orally for two weeks, 20 or 30 drops three times a day before meals.

Homeopathy – therapeutic treatment with small medicinal doses of any one drug, based on the principle of similarity and personally prescribed by a homeopathic doctor, taking into account all the personal characteristics of the patient, is usually effective and can lead to recovery. By committing to serious and long-term treatment and following all the doctor’s prescriptions, you can defeat the disease and achieve permanent remission. Especially when treating such a multifactorial and individual disease as psoriasis. You can take homeopathic medicines for as long as you like, since there are no undesirable effects from taking them. However, prescribing them to yourself is unacceptable; it may be ineffective and may even cause harm. To receive individual prescriptions that will be most effective for a particular patient, you need to consult a homeopathic doctor.

If it is impossible to obtain advice from a professional homeopath, you can use pharmacy homeopathic medicines produced by pharmaceutical companies in compliance with homeopathic dosages and technological principles.

Psoriatic ointment, with the main component – ​​mahonia holly. The ointment is addressed to patients with the initial stages of the disease in a mild form. It can be used by pregnant and breastfeeding women under medical supervision.

More than 30 medicines are mentioned in the homeopathic medicine for the treatment of different forms and localizations of psoriatic rashes. The most frequently used of them are used as part of pharmaceutical combination products recommended for this disease.

Psorinocheel N– complex drops containing 11 main drugs used to treat psoriasis (psorinum, sulfur, thuja, sodium muraticum, etc.). The drug relieves inflammation and intoxication, normalizes immunity, and removes manifestations of exudation. By activating the internal reserves of the body, Psorinoheel N stops the degenerative process in the skin and promotes its regeneration. Dosing is individual. The standard regimen involves starting treatment with one drop twice or thrice a day, each day increasing the single dosage by one drop until reaching 8-10 drops, which are dripped directly under the tongue and held there until absorbed. It is possible to dissolve a single dose of the drug in 5 ml of water or drop the daily dose into a glass of water and drink throughout the day at regular intervals (store the solution in a dark place).

Solution Loma Lux Psoriasis contains homeopathic dilutions of nickel and potassium sulfate, potassium bromides, sodium, zinc. Hydrobromic acid salts are able to regulate the functioning of the immune system, reduce the production of pro-inflammatory factors and stimulate cellular renewal. Nickel salt of sulfuric acid reduces the superficial sensitivity of the skin and promotes detoxification of the body, catalyzes metabolic processes. Potassium – moisturizes and eliminates flaking, tones and normalizes cellular respiration. Contraindicated in case of sensitivity to the ingredients, renal failure, during pregnancy and breastfeeding. Dosing is proportional to the patient's body weight; half to two teaspoons are taken on an empty stomach once and abstain from food and drink for an hour.

Homeopathic granules Psoroderm– a complex preparation of seven ingredients:

• Bufo (Bufo rana) – affects the central nervous genitourinary and lymphatic system, heals the skin;
• Natrium muriaticum - indicated for significant metabolic disorders, dry and exudative rashes;
• Oleander - skin diseases accompanied by itching, increased irritability from contact with clothing;
• Psorinum – affects the lymphatic system, skin and mucous membranes, secretory glands, nervous system; prescribed for chronic diseases that are difficult to treat;
• Sulfur – strengthens the immune system, prescribed for many chronic dermatoses;
• Thuja (Thuja) – pathological tissue growths, rashes, growths, dry skin;
• Cicuta virosa has a positive effect on the epithelial surface of the skin and mucous membranes, the brain and spinal cord.
• periodically, preferably in spring and autumn, cleanse the body of toxins in order to improve the functioning of the excretory organs and relieve the skin from overload (this can be done using ready-made dietary supplements, infusions, and folk methods for cleansing);
• monitor normal bowel function, avoid diarrhea and constipation or their alternation;
• try to exclude gluten (found in cereals) and lactose (in dairy products) from the menu for a month or two; if the condition improves, then you should eliminate them forever;
• do not overeat;
• use sea water (you can irrigate the affected areas of the body with it once a day if it is not possible to arrange sea bathing);
• use sea salt when cooking;
• take half-hour hot (≈ 38-39 ° C) baths with a rich infusion of licorice, which is considered a natural cortisone;
• use brewer's yeast, flaxseed oil and nettles (in any form: fresh - in salads and borscht; dried - in tea and infusion).

Psoriasis in the intimate area is quite common in both men and women. The disease brings serious discomfort and interferes with normal sexual life. Where should the patient go? How to get rid of unpleasant symptoms? How to properly treat psoriasis? Important and useful information can be read below.

Symptoms

Genital psoriasis is of two types: vulgar and inverse. The clinical picture of these varieties is significantly different. Women report the following symptoms:

1. In the vulgar form, the main symptom is the appearance of pink-red rashes with a silvery surface in the form of scales on the pubis and labia. Excessive peeling is a characteristic sign of psoriasis of the labia.
2. With inverse psoriasis, the rashes are localized in the inguinal folds. The presence of high temperature and high humidity promotes the addition of a secondary infection, bacterial or fungal. In the case of inverse psoriasis, there is no peeling.

Clinical manifestations of psoriasis in men:

1. With the plaque type of psoriasis, a rash occurs in the form of red or pink rashes on the pubis, head of the penis, shaft and even on the foreskin, on the scrotum.
2. Inverse psoriasis occurs in the form of a rash in the folds of the groin, with the presence of weeping. There are also frequent cases of infection, which makes diagnosis difficult.

In both cases, many patients of both sexes complain of severe itching, burning in the pubic area and around the anus. Often there is a serious deterioration in general condition.

It is important to remember that psoriasis in the intimate area is often combined with the presence of plaques in other areas of the body. The presence of rashes of other localization simplifies diagnosis.

Causes of the disease

The appearance of disease symptoms in the bikini area is influenced by a variety of factors. Dermatologists cannot always reliably establish the etiology of psoriasis, but they usually identify the following triggers:

• dysfunction of the immune system;
• overweight;
• bad habits;
• place of residence of a person;
• chronic infections;
• endured stress.

There has been a correlation between psoriatic plaques on the genitals and chronic stress in patients. Wearing synthetic and low-quality underwear, trousers or leggings also has a provoking effect.

Diagnostics

If even a single rash appears in the intimate area, you should visit a doctor. He will conduct an examination and prescribe a comprehensive examination to make an accurate diagnosis. The following research methods are used:

• blood analysis;
• dermoscopy;
• scraping from the surface of the affected area.

In many cases, psoriasis is difficult to distinguish from other genital diseases. Therefore, to exclude or confirm the diagnosis, consultation with specialists (gynecologist, urologist) may be required.

Important! At the diagnostic stage, it is necessary to determine the type of psoriasis, its stage and intensity - the nature of the treatment depends on this.

Treatment

To treat genital psoriasis, topical agents are prescribed: creams, ointments. Groups of drugs for external use:

• with corticosteroids;
• moisturizing;
• drying;
• healing.

Before smearing the affected areas, a person must take a shower. For hygienic care of the bikini area, herbal decoctions or clean warm water are perfect. Plaques in the intimate area should be smeared several times a day.

Creams and ointments alternate with each other because they all have different properties:

1. Hormonal creams are effective for severe itching, swelling and redness. They are prescribed for short periods due to the risk of addiction and tolerance. You can smear them on both the skin and mucous membranes.
2. Moisturizing preparations prevent cracking of the skin; they can be smeared only for vulgar psoriasis.
3. Drying agents eliminate weeping and allow the affected area to heal.
4. Healing agents accelerate the process of tissue regeneration. In places where the surface becomes wet, they should be applied to the skin at intervals after drying preparations.

If local treatment does not help, tablets are prescribed. It is worth emphasizing that when taking general medications, local therapy cannot be stopped; psoriasis lesions on the pubis and genital area must be constantly smeared.

In cases of severe itching in the pubic area and around the anus, many patients scratch the skin until abrasions and scratching appear. Wounds are entry points for various infections. An infectious disease should be treated taking into account its etiology.

Patients may be nervous and have fears and anxieties. In this case, the doctor prescribes sedatives and hypnotics as part of treatment. Sometimes a consultation with a psychotherapist is prescribed. Treatment of increased nervousness and irritability is a basic step in the fight against psoriasis, since a stressful state only aggravates the disease.

Unfortunately, men and women are often embarrassed to see a doctor or treat themselves. The initial visit to a medical specialist is most often associated with an extensive lesion, the formation of erosive areas and severe pain. Many patients independently begin to apply various products to the affected areas, which leads to worsening.

Important! If the prescribed medications do not help the patient for a long time, the doctor refers him to inpatient treatment. With the rapid spread of pathology, the disease should also be treated in a hospital setting.

It is very important to follow your doctor’s recommendations and review your lifestyle and daily diet.

1. Quitting alcohol and smoking will reduce the frequency of relapses and reduce the spread of the pathological process in the intimate area.
2. Patients are recommended to wear loose clothing made from natural fabrics. Underwear should not press or rub.
3. Walking and regular sleep will be helpful.
4. Sexual activity is not prohibited if a person does not experience pain or discomfort in intimate places. Psoriasis is a non-infectious disease and is not transmitted through sexual contact.
5. Shaving the intimate area is prohibited - excessive trauma to the pubic skin provokes the appearance of new foci of psoriasis.
6. Caffeinated drinks, fried, spicy foods and sweets should be avoided as these foods increase irritation in the genital area.

Treatment of psoriasis in the intimate area should be carried out with dynamic observation and under the control of laboratory parameters. The success of therapy depends 70% on the patient himself.