Expert Consensus Offers Age-Specific Road Map for Diagnosing Genital Psoriasis

A new consensus manuscript from the Genital Psoriasis Wellness Consortium, published in the American Journal of Clinical Dermatology, offers comprehensive, age-stratified guidance for clinicians managing genital psoriasis—a manifestation that affects the majority of patients with psoriasis over the course of their disease yet is routinely missed in clinical practice.¹

The manuscript, developed through a modified Delphi process requiring a greater than or equal to 75% agreement on a 7-point Likert scale among multidisciplinary US-based experts, provides structured recommendations across 3 demographic groups: pediatric patients, adults, and older individuals. The approach reflects a deliberate editorial choice to organize guidance by patient population rather than by thematic category, a structure designed to reduce friction at the point of care.

Genital involvement occurs in more than 60% of individuals with psoriasis at some point in their disease course. Despite this prevalence, the condition is substantially underdiagnosed, a gap the authors attribute to both clinician behavior (routine genital assessment is not universally practiced) and patient reluctance to raise the topic due to its sensitive nature.²

“Genital psoriasis is one of the most impactful yet consistently overlooked manifestations of psoriatic disease. Although it will affect the majority of individuals with psoriasis at some point in their lives, genital psoriasis remains vastly underdiagnosed because clinicians aren’t routinely asking, and patients are hesitant to bring it up due to its sensitive nature. Our consensus work represents a 'call to action' and an important step forward, giving clinicians a comprehensive, age-specific road map to approach genital psoriasis with the same rigor they bring to every other aspect of dermatologic care. It has the potential to meaningfully direct the course of outcomes for individuals with genital psoriasis who have gone either undiagnosed or untreated for far too long.”

—Michael J. Payette, MD, MBA, FAAD, dermatologist, Central Connecticut Dermatology; associate clinical professor, UConn Health; lead author

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Key Recommendations

The consensus guidance addresses 4 principal areas of clinical practice:

• Routine genital assessment as part of comprehensive skin examinations, rather than deferring to patient-initiated disclosure
• Verbal consent, stigma-reducing communication, and chaperone protocols for minors, acknowledging the added complexity of examining genital areas in pediatric populations
• Age-specific treatment considerations individualized for pediatric, adult, and older patients, recognizing that disease presentation, comorbidity burden, and treatment tolerability differ across these groups
• Minimization of long-term topical corticosteroid use, with guidance to consider nonsteroidal topical options when appropriate, given the anatomical sensitivity of genital skin

Clinical Context

The consortium’s guidance follows an earlier publication and is intended to build on foundational consensus work with a focus on practical, real-world application. The authors frame it explicitly as a call to action, urging clinicians to approach genital psoriasis with the same diagnostic rigor applied to other aspects of dermatologic care.

Nonsteroidal topical therapies have become increasingly relevant in managing inflammatory dermatoses in sensitive skin areas, and the recommendation to limit long-term corticosteroid use in the genital region aligns with broader treatment principles around steroid-related adverse effects—including skin atrophy and absorption—in occluded anatomical sites.

The manuscript also underscores the quality-of-life impact of genital psoriasis, which has been associated with sexual dysfunction, psychological distress, and reduced treatment adherence. Targeting earlier diagnosis and individualized treatment plans may help address those downstream effects.

The Genital Psoriasis Wellness Consortium is a multidisciplinary group of US-based clinicians supported by Arcutis Biotherapeutics. The consortium’s work aims to translate clinical expertise into practical educational content for dermatologists and other providers managing psoriatic disease.

References

1. New expert consensus provides age-specific guidance for improving care for individuals with genital psoriasis published in the American Journal of Clinical Dermatology. News release. Arcutis Biotherapeutics. June 3, 2026. Accessed June 3, 2026. https://tinyurl.com/bdd5pwyd
2. Yi OS, Huan KY, Har LC, Ali NM, Chiang TW. Genital psoriasis: a prospective, observational, single-centre study on prevalence, clinical features, risk factors, and its impact on quality of life and sexual health. Indian J Dermatol. 2022;67(2):205. doi:10.4103/ijd.ijd_754_21