Anogenital psoriasis: clinical picture and therapy

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Abstract

Psoriasis presenting with anogenital lesions is an important medical and social problem that is not sufficiently covered in the literature.

The genitals and perianal area are involved in severe plaque and inverse psoriasis. Occasionally, the disease can be localized only in the anogenital zone. Diagnosis of psoriasis with localization on the genitals and/or perianal area is difficult, which is associated with the anatomical and physiological characteristics of the affected area. The manifestations of psoriasis become exudative, infiltration of papules and plaques is expressed little, the borders of rashes lose clarity, peeling on the skin is expressed weakly, in the depth of the folds due to maceration and friction is absent. Subjectively significant localization of the process, its prolonged course, pruritus lead to significant violations of the quality of life of patients and serve as prerequisites for the formation of anxiety-depressive disorders and sexual dysfunction

Diagnosis and treatment of anogenital psoriasis presents significant challenges. Clinical guidelines tend to emphasize external therapy with topical corticosteroids and calcineurin inhibitors; in recent years, the efficacy of genetically engineered biological agents, including interleukin-17 inhibitors and phosphodiesterase-4 inhibitors, has been considered.

The presented review systematizes information about anogenital psoriasis, peculiarities of its epidemiology, clinical picture, diagnosis and approaches to therapy.

About the authors

Irina O. Smirnova

Saint-Petersburg State University; City Dermatovenerological Dispensary

Email: driosmirnova@yandex.ru
ORCID iD: 0000-0001-8584-615X
SPIN-code: 5518-6453

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Kristina D. Khazhomiya

Saint-Petersburg State University; City Dermatovenerological Dispensary

Author for correspondence.
Email: christinakhazhomiya@gmail.com
ORCID iD: 0000-0002-2997-6109
SPIN-code: 2796-4870
Russian Federation, Saint Peterburg; Saint Peterburg

Olga N. Smirnova

North-Western State Medical University named after I.I. Mechnikov

Email: dronsmirnova@mail.ru
ORCID iD: 0000-0002-1045-9689
SPIN-code: 2438-3136

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg

Polina D. Ptashnikova

Saint-Petersburg State University

Email: enternita7@yandex.ru
ORCID iD: 0000-0003-4699-1746
SPIN-code: 8715-3940
Russian Federation, Saint Petersburg

References

  1. Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol. 2017;31(2):205–212. doi: 10.1111/jdv.13854
  2. Griffiths CE, Armstrong AW, Gudjonsson JE, Barker JN. Psoriasis. Lancet. 2021;397(10281):1301–1315. doi: 10.1016/S0140-6736(20)32549-6
  3. Psoriasis. Clinical recommendations. Russian Society of Dermatovenerologists and Cosmetologists; 2020. 77 р. (In Russ).
  4. Meeuwis KA, Potts Bleakman A, van de Kerkhof PC, et al. Prevalence of genital psoriasis in patients with psoriasis. J Dermatolog Treat. 2018;29(8):754–760. doi: 10.1080/09546634.2018.1453125
  5. Wang G, Li C, Gao T, Liu Y. Clinical analysis of 48 cases of inverse psoriasis: A hospital-based study. Eur J Dermatol. 2005;15(3):176–178.
  6. Kapila S, Bradford J, Fischer G. Vulvar psoriasis in adults and children: A clinical audit of 194 cases and review of the literature. J Low Genit Tract Dis. 2012;16(4):364–371. doi: 10.1097/LGT.0b013e31824b9e5e
  7. Belousova IE, Ignatovsky AV, Konstantinova AM, et al. Non-infectious dermatoses of the vulva: clinic, diagnosis, treatment: An illustrated guide for doctors. Moscow: GEOTAR-Media; 2021. 240 р. EDN: WLCASI doi: 10.33029/9704-6008-5-NDV-1-240
  8. Meeuwis KA, De Hullu JA, Massuger LF, et al. Genital psoriasis: A systematic literature review on this hidden skin disease. Acta Derm Venereol. 2011;91:5–11.
  9. Hong JJ, Mosca ML, Hadeler EK, et al. Genital and inverse / Intertriginous psoriasis: An updated review of therapies and recommendations for practical management. Dermatol Ther (Heidelb). 2021;11(3):833–844. doi: 10.1007/s13555-021-00536-6
  10. Da Silva N, von Stülpnagel C, Langenbruch A, et al. Disease burden and patient needs and benefits in anogenital psoriasis: Developmental specificities for person-centred healthcare of emerging adults and adults. J Eur Acad Dermatol Venereol. 2020;34(5):1010–1018. doi: 10.1111/jdv.16076
  11. Larsabal M, Ly S, Sbidian E, et al. GENIPSO: A French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis. Br J Dermatol. 2019;180(3):647–656. doi: 10.1111/bjd.17147
  12. Dopytalska K, Sobolewski P, Błaszczak A, et al. Psoriasis in special localizations. Reumatologia. 2018;56(6):392–398. doi: 10.5114/reum.2018.80718
  13. Mahajan R, Kumaran MS, Narang T, et al. Genital psoriasis among Indians: A prospective cross-sectional study. Australas J Dermatol. 2015;56(1):e18–20. doi: 10.1111/ajd.12077
  14. Quintero CA, Martínez MA. Perianal psoriasis as the first manifestation of the disease. J Coloproctol. 2022;42(4):345–347.
  15. Gisondi P, Bellinato F, Girolomoni G. Topographic differential diagnosis of chronic plaque psoriasis: Challenges and tricks. J Clin Med. 2020;9(11):3594. doi: 10.3390/jcm9113594
  16. Merola JF, Qureshi A, Husni ME. Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails. Dermatol Ther. 2018;31(3):e12589. doi: 10.1111/dth.12589
  17. Marcos-Pinto A, Soares-de-Almeida L, Borges-Costa J. Nonvenereal penile dermatoses: A retrospective study. Indian Dermatol Online J. 2018;9(2):96–100. doi: 10.4103/idoj.IDOJ_23_17
  18. Fischer G, Rogers M. Vulvar disease in children: A clinical audit of 130 cases. Pediatr Dermatol. 2000;17(1):1–6. doi: 10.1046/j.1525-1470.2000.01701.x
  19. Zamirska A, Reich A, Berny-Moreno J, et al. Vulvar pruritus and burning sensation in women with psoriasis. Acta Derm Venereol. 2008;88(2):132–135. doi: 10.2340/00015555-0372
  20. Singer C, Coşoveanu S, Stoica LE, et al. Psoriasis vulgaris in children: Case presentation. Curr Health Sci J. 2016;42(1):97–101. doi: 10.12865/CHSJ.42.01.14
  21. Kelly A, Ryan C. Genital psoriasis: Impact on quality of life and treatment options. Am J Clin Dermatol. 2019;20(5):639–646. doi: 10.1007/s40257-019-00447-5
  22. Czuczwar P, Stępniak A, Goren A, et al. Genital psoriasis: A hidden multidisciplinary problem: A review of literature. Ginekol Pol. 2016;87(10):717–721. doi: 10.5603/GP.2016.0074
  23. Larsabal M, Ly S, Sbidian E, et al. GENIPSO: A French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis. Br J Dermatol. 2019;180(3):647–656. doi: 10.1111/bjd.17147
  24. Farber EM, Nall L. Perianal and intergluteal psoriasis. Cutis. 1992;50(5):336–338.
  25. Bolognia JL, Schafer JV, Cerroni L. Dermatology. Vol. 1. 4th ed. Elsevier; 2018.
  26. Mahajan R, Kumaran MS, Narang T, et al. Genital psoriasis among Indians: A prospective cross-sectional study. Australas J Dermatol. 2015;56(1):e18–20. doi: 10.1111/ajd.12077
  27. Cather JC, Ryan C, Meeuwis K, et al. Patients’ perspectives on the impact of genital psoriasis: A qualitative study. Dermatol Ther (Heidelb). 2017;7(4):447–461. doi: 10.1007/s13555-017-0204-3
  28. Yang EJ, Beck KM, Sanchez IM, et al. The impact of genital psoriasis on quality of life: A systematic review. Psoriasis (Auckl). 2018;8:41–47. doi: 10.2147/PTT.S169389
  29. Malakouti M, Brown GE, Leon A, et al. The dermatologic intimacy scale: Quantitatively measuring the impact of skin disease on intimacy. J Dermatolog Treat. 2017;28(4):347–352. doi: 10.1080/09546634.2016.1252032
  30. Wilson FC, Icen M, Crowson CS, et al. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: A population-based study. Arthritis Rheum. 2009;61(2):233–239. doi: 10.1002/art.24172. Erratum in: Arthritis Rheum. 2010;62(4):574.
  31. Patrizi A, Venturi M, Scorzoni R, et al. Nail dystrophies, scalp and intergluteal/perianal psoriatic lesions: Risk factors for psoriatic arthritis in mild skin psoriasis? G Ital Dermatol Venereol. 2014;149(2):177–184.
  32. Cabete J, Torres T, Vilarinho T, et al. Erectile dysfunction in psoriasis patients. Eur J Dermatol. 2014;24(4):482–486. doi: 10.1684/ejd.2014.2388
  33. Duarte GV, Calmon H, Radel G, et al. Psoriasis and sexual dysfunction: Links, risks, and management challenges. Psoriasis (Auckl). 2018;8:93–99. doi: 10.2147/PTT.S159916
  34. Chen YJ, Chen CC, Lin MW, et al. Increased risk of sexual dysfunction in male patients with psoriasis: A nationwide population-based follow-up study. J Sex Med. 2013;10(5):1212–1218.
  35. Ryan C, Sadlier M, de Vol E, et al. Genital psoriasis is associated with significant impairment in quality of life and sexual functioning. J Am Acad Dermatol. 2015;72(6):978–983. doi: 10.1016/j.jaad.2015.02.1127
  36. Meeuwis KA, de Hullu JA, van de Nieuwenhof HP, et al. Quality of life and sexual health in patients with genital psoriasis. Br J Dermatol. 2011;164(6):1247–1255. doi: 10.1111/j.1365-2133.2011.10249.x
  37. Lopes Filho LL, Lopes IM, Lopes LR, et al. Mammary and extramammary Paget’s disease. Ann Bras Dermatol. 2015;90(2):225–231. doi: 10.1590/abd1806-4841.20153189
  38. Borghi A, Virgili A, Corazza M. Dermoscopy of inflammatory genital diseases: Practical insights. Dermatol Clin. 2018;36(4):451–461. doi: 10.1016/j.det.2018.05.013
  39. Lallas A, Apalla Z, Argenziano G, et al. Dermoscopic pattern of psoriatic lesions on specific body sites. Dermatology. 2014;228(3):250–254. doi: 10.1159/000357914
  40. Merola JF, Bleakman AP, Gottlieb AB, et al. The static physician’s global assessment of genitalia: A clinical outcome measure for the severity of genital psoriasis. J Drugs Dermatol. 2017;16(8):793–799.
  41. Gottlieb AB, Kirby B, Ryan C, et al. The development of a patient-reported outcome measure for assessment of genital psoriasis symptoms: The Genital Psoriasis Symptoms Scale (GPSS). Dermatol Ther (Heidelb). 2018;8(1):45–56. doi: 10.1007/s13555-017-0213-2
  42. Gottlieb AB, Kirby B, Ryan C, et al. The development of the Genital Psoriasis Sexual Frequency Questionnaire (GenPs-SFQ) to assess the impact of genital psoriasis on sexual health. Dermatol Ther (Heidelb). 2018;8(1):33–44. doi: 10.1007/s13555-017-0212-3
  43. Beck KM, Yang EJ, Sanchez IM, Liao W. Treatment of genital psoriasis: A systematic review. Dermatol Ther. 2018;8(4):509–525. doi: 10.1007/s13555-018-0257-y
  44. Reynolds KA, Pithadia DJ, Lee EB, Wu JJ. Treatments for inverse psoriasis: A systematic review. J Dermatol Treat. 2020;31(8):786–793. doi: 10.1080/09546634.2019.1620912
  45. Khosravi H, Siegel MP, van Voorhees AS, Merola JF. Treatment of inverse/intertriginous psoriasis: Updated guidelines from the medical board of the national psoriasis foundation. J Drugs Dermatol. 2017;16(8):760–766.
  46. Lebwohl MG, Tan MH, Meador SL, Singer G. Limited application of fluticasone propionate ointment, 0.005% in patients with psoriasis of the face and intertriginous areas. J Am Acad Dermatol. 2001;44(1):77–82. doi: 10.1067/mjd.2001.110046
  47. Stacey SK, McEleney M. Topical corticosteroids: Choice and application. Am Fam Physician. 2021;103(6):337–343.
  48. Kreuter A, Sommer A, Hyun J, et al. 1% pimecrolimus, 0.005% calcipotriol, and 0.1% betamethasone in the treatment of intertriginous psoriasis: A double-blind, randomized controlled study. Arch Dermatol. 2006;142(9):1138–1143. doi: 10.1001/archderm.142.9.1138
  49. Maul JT, Anzengruber F, Conrad C, et al. Topical treatment of psoriasis vulgaris: The swiss treatment pathway. Dermatology. 2021;237(2):166–178. doi: 10.1159/000512930
  50. Amiri D, Schwarz CW, Gether L, Skov L. Safety and efficacy of topical calcineurin inhibitors in the treatment of facial and genital psoriasis: A systematic review. Acta Derm Venereol. 2023;103:adv00890. doi: 10.2340/actadv.v103.6525
  51. Lebwohl M, Freeman AK, Chapman MS, et al. Tacrolimus ointment is effective for facial and intertriginous psoriasis. J Am Acad Dermatol. 2004;51(5):723–730. doi: 10.1016/j.jaad.2004.07.011
  52. Bissonnette R, Nigen S, Bolduc C. Efficacy and tolerability of topical tacrolimus ointment for the treatment of male genital psoriasis. J Cutan Med Surg. 2008;12(5):230–234. doi: 10.2310/7750.2008.07055
  53. Gribetz C, Ling M, Lebwohl M, et al. Pimecrolimus cream 1% in the treatment of intertriginous psoriasis: A double-blind, randomized study. J Am Acad Dermatol. 2004;51(5):731–738. doi: 10.1016/j.jaad.2004.06.010
  54. Lo A, Greenzaid JD, Gantz HY, et al. Clinical pharmacokinetics and pharmacodynamics of topical non-biological therapies for psoriasis patients. Expert Opin Drug Metab Toxicol. 2024;20(4):235-248. doi: 10.1080/17425255.2024.2337749
  55. Reitamo S, Rissanen J, Remitz A, et al. Tacrolimus ointment does not affect collagen synthesis: Results of a single-center randomized trial. J Invest Dermatol. 1998;111(3):396–398. doi: 10.1046/j.1523-1747.1998.00323.x
  56. Lebwohl M, Ting PT, Koo JY. Psoriasis treatment: Traditional therapy. Ann Rheum Dis. 2005;64(Suppl. 2):ii83–ii86. doi: 10.1136/ard.2004.030791
  57. Norris DA. Mechanisms of action of topical therapies and the rationale for combination therapy. J Am Acad Dermatol. 2005;53(1, Suppl. 1):S17–25. doi: 10.1016/j.jaad.2005.04.027
  58. Segaert S, Ropke M. The biological rationale for use of vitamin d analogs in combination with corticosteroids for the topical treatment of plaque psoriasis. J Drugs Dermatol. 2013;12(8):e129–137.
  59. Norsgaard H, Kurdykowski S, Descargues P, et al. Calcipotriol counteracts betamethasone-induced decrease in extracellular matrix components related to skin atrophy. Arch Dermatol Res. 2014;306(8):719–729. doi: 10.1007/s00403-014-1485-3
  60. Freund YR, Akama T, Alley MR, et al. Boron-based phosphodiesterase inhibitors show novel binding of boron to PDE4 bimetal center. FEBS Lett. 2012;586(19):3410–3414. doi: 10.1016/j.febslet.2012.07.058
  61. Zane LT, Hughes MH, Shakib S. Tolerability of crisaborole ointment for application on sensitive skin areas: A randomized, double-blind, vehicle-controlled study in healthy volunteers. Am J Clin Dermatol. 2016;17(5):519–526. doi: 10.1007/s40257-016-0204-6
  62. Dopytalska K, Sobolewski P, Błaszczak A, et al. Psoriasis in special localizations. Reumatologia. 2018;56(6):392–398. doi: 10.5114/reum.2018.80718
  63. Hashim PW, Chima M, Kim HJ, et al. Crisaborole 2% ointment for the treatment of intertriginous, anogenital, and facial psoriasis: A double-blind, randomized, vehicle-controlled trial. J Am Acad Dermatol. 2020;82(2):360–365. doi: 10.1016/j.jaad.2019.06.1288
  64. Liu Y, Li W. Crisaborole ointment as treatment for genital psoriasis. J Cosmet Dermatol. 2022;21(9):4080–4081. doi: 10.1111/jocd.14706
  65. Finlay AY. Current severe psoriasis and the rule of tens. Br J Dermatol. 2005;152(5):861–867. doi: 10.1111/j.1365-2133.2005.06502.x
  66. Schmitt J, Wozel G. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology. 2005;210(3):194–199. doi: 10.1159/000083509
  67. Strober B, Ryan C, van de Kerkhof P, et al.; International Psoriasis Council Board Members and Councilors. Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council. J Am Acad Dermatol. 2020;82(1):117–122. doi: 10.1016/j.jaad.2019.08.026
  68. Papp K, Gulliver W, Lynde C, et al.; Canadian Psoriasis Guidelines Committee. Canadian guidelines for the management of plaque psoriasis: Overview. J Cutan Med Surg. 2011;15(4):210–219. doi: 10.2310/7750.2011.10066
  69. Kovalyova YuS. Genital dermatoses of non-infectious etiology in men. Effective pharmacotherapy. 2019;15(10):34–39. EDN: FNJIDN doi: 10.33978/2307-3586-2019-15-10-34-39
  70. Sokolovskiy E.V., Kokhan M.M. Clinical evidence of therapy for genital psoriasis by biologic agents. Vestnik dermatologii i venerologii. 2021;97(2):50–55. EDN: HHSXIG doi: 10.25208/vdv1217
  71. Berekmeri A, Mahmood F, Wittmann M, Helliwell P. Tofacitinib for the treatment of psoriasis and psoriatic arthritis. Expert Rev Clin Immunol. 2018;14(9):719–730. doi: 10.1080/1744666X.2018.1512404
  72. Korotaeva TV, Loginova E.U. Results of studying the clinical efficacy and safety of tofacitinib in the treatment of psoriatic arthritis. Modern rheumatology journal = Sovremennaya revmatologiya. 2019;13(2):112–118. EDN: NTUSHE doi: 10.14412/1996-7012-2019-2-112-118
  73. Tajalli M, Kabir S, Vance TM, Qureshi AA. Effective use of oral tofacitinib and phototherapy in a patient with concomitant alopecia areata, vitiligo, and plaque and inverse psoriasis. Clin Case Rep. 2020;8(5):819–822. doi: 10.1002/ccr3.2759
  74. Liu LY, Strassner JP, Refat MA, et al. Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure. J Am Acad Dermatol. 2017;77(4):675–682.e1. doi: 10.1016/j.jaad.2017.05.043
  75. Strober BE, Gottlieb AB, van de Kerkhof PC, et al. Benefit-risk profile of tofacitinib in patients with moderate-to-severe chronic plaque psoriasis: Pooled analysis across six clinical trials. Br J Dermatol. 2019;180(1):67–75. doi: 10.1111/bjd.17149
  76. Burlando M, Herzum A, Carmisciano L, et al.Biological therapy in genital psoriasis in women. Dermatol Ther. 2020;33(1):e13110. doi: 10.1111/dth.13110
  77. Al-Mutairi N, Eassa BI. A randomized controlled ixekizumab vs secukinumab trial to study the impact on sexual activity in adult patients with genital psoriasis. Expert Opin Biol Ther. 2021;21(2):297–298. doi: 10.1080/14712598.2021.1843629
  78. Yosipovitch G, Foley P, Ryan C, et al. Ixekizumab improved patient-reported genital psoriasis symptoms and impact of symptoms on sexual activity vs placebo in a randomized double-blind study. J Sex Med. 2018;15(11):1645–1652. doi: 10.1016/j.jsxm.2018.09.004
  79. Ryan C, Menter A, Guenther L, et al. Efficacy and safety of ixekizumab in a randomized, double-blinded, placebo-controlled phase IIIb study of patients with moderate-to-severe genital psoriasis. Br J Dermatol. 2018;179(4):844–852. doi: 10.1111/bjd.16736
  80. Guenther L, Potts Bleakman A, Weisman J, et al. Ixekizumab results in persistent clinical improvement in moderate-to-severe genital psoriasis during a 52 week, randomized, placebo-controlled, phase 3 clinical trial. Acta Derm Venereol. 2020;100(1):adv00006. doi: 10.2340/00015555-3353
  81. Merola JF, Ghislain PD, Dauendorffer JN, et al. Ixekizumab improves secondary lesional signs, pain and sexual health in patients with moderate-to-severe genital psoriasis. J Eur Acad Dermatol Venereol. 2020;34(6):1257–1262. doi: 10.1111/jdv.16181
  82. Burlando M, Herzum A, Carmisciano L, et al. Biological therapy in genital psoriasis in women. Dermatol Ther. 2020;33(1):e13110. doi: 10.1111/dth.13110
  83. Galluzzo M, Talamonti M, Cioni A, et al. Efficacy of tildrakizumab for the treatment of difficult-to-treat areas: Scalp, nail, palmoplantar and genital psoriasis. J Clin Med. 2022;11(9):2631. doi: 10.3390/jcm11092631
  84. Licata G, Danzuso GC, Fiorella C, et al. Efficacy, safety and patient’s satisfaction for treatment of genital psoriasis with tildrakizumab: A case series and review of literature. J Eur Acad Dermatol Venereol. 2022;36(11):e916–e918. doi: 10.1111/jdv.18368
  85. Ceccarelli G, Simonacci M. Exclusively genital psoriasis successfully treated with risankizumab. Dermatol Ther. 2022;35(8):e15591. doi: 10.1111/dth.15591
  86. Smirnova IO. Adjuvant therapy of psoriasis. Antimicrobial peptides in the crosshairs. Effective pharmacotherapy. 2022;18(39):12–14. EDN: GHZRRE
  87. Takahashi T, Yamasaki K. Psoriasis and antimicrobial peptides. Int J Mol Sci. 2020;21(18):6791. doi: 10.3390/ijms21186791
  88. Raef HS, Elmariah SB. Vulvar pruritus: A review of clinical associations, pathophysiology and therapeutic management. Front Med (Lausanne). 2021;8:649402. doi: 10.3389/fmed.2021.649402
  89. Satoh T, Yokozeki H, Murota H, et al. 2020 Guidelines for the diagnosis and treatment of cutaneous pruritus. J Dermatol. 2021;48(9):e399–e413. doi: 10.1111/1346-8138.16066
  90. Gouin O, Lebonvallet N, L’Herondelle K, et al. Self-maintenance of neurogenic inflammation contributes to a vicious cycle in skin. Exp Dermatol. 2015;24(10):723–726. doi: 10.1111/exd.12798
  91. Cohen AD, Andrews ID, Medvedovsky E, et al. Similarities between neuropathic pruritus sites and lichen simplex chronicus sites. Isr Med Assoc J. 2014;16(2):88–90.
  92. Heuberger DM, Schuepbach RA. Protease-activated receptors (PARs): Mechanisms of action and potential therapeutic modulators in PAR-driven inflammatory diseases. Thromb J. 2019;17:4. doi: 10.1186/s12959-019-0194-8. Erratum in: Thromb J. 2019;17:22.

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2. Fig. 1. Clinical manifestations of psoriasis of the anogenital area: psoriatic balanitis (1); vivid rashes with weakly expressed desquamation involving the skin of the trunk, pubis and scrotum (2), perineum (3), perianal area (4); clinical and dermatoscopic picture of psoriatic balanitis with evenly distributed pitting vessels (5, 6); symmetrical and predominantly unilateral lesion of the labia majora (7, 8); process with irritation dermatitis on the background of menopausal genitourinary syndrome with urinary incontinence (9) and involvement of the labia majora, labia minora, perineum and perianal area with Kebner’s phenomenon on the background of using daily pads (10, 11); pustular psoriasis on the background of long-term uncontrolled use of topical corticosteroids: clinical (12, 13), dermatoscopic (14) and histological (15) picture with formation of massive crusts on the surface of papules, acanthosis of irregular character, exocytosis of neutrophilic granulocytes into the epithelium and formation of large Munro microabscesses.

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3. Fig. 2. Isolated psoriatic lesion of the perianal region. Features of clinical picture with a bright slightly infiltrated plaque (a) and dynamics of the process against the background of consecutive application of topical corticosteroids of medium potency for 3 weeks (b), calcineurin inhibitors for 4 weeks daily (c) and further in an intermittent mode (d).

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4. Fig. 3. Psoriatic lesion of the pubis and penis. Features of the clinical picture with weakly expressed desquamation (a) and the dynamics of the process against the background of treatment with the combined preparation of calciptoriol and betamethasone for 4 weeks (b).

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7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

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10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».