Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.
Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.
Int J Dermatol. 2022 May;61(5):607-610. doi: 10.1111/ijd.15938. Epub 2021 Oct 11.
Atopic dermatitis is a systemic and immune-mediated dermatological disease that comprises a wide group of physiological and psychological comorbidities. Within the latter, the evaluation of anxiety and depression has been the subject of numerous studies, but sexual dysfunction (SD) is a fact that is rarely addressed in the literature. The objective of the present study is to assess the prevalence of SD in a cohort of patients with moderate-to-severe atopic dermatitis (AD) and to establish the possible impact of dupilumab therapy on it.
A cross-sectional study was performed. Recruited patients had been diagnosed with moderate-to-severe AD at the Dermatology Unit of the Hospital Universitario San Cecilio, Granada, Spain, from July 1, 2019, through June 30, 2020. They were followed up for a 6-month period during which the impact of dupilumab treatment was measured. The main variable under study, sexual dysfunction, was evaluated differently according to gender. Regarding the male patients, the International Index Erectile Function (IIEF-5) was applied, whereas for female patients, the questionnaire "Female Sexual Function Index" was used.
Our study included 31 patients, 18 men and 13 women. Men's mean age was 35 +/- 14.55 years, while that of women was 33 +/- 10.46 years. Seventy-nine percent of patients in our series (n = 22) had SD compared to 29% (n = 9) who did not. A total of 66.9% of males and 76.9% (n = 10) of females sampled, suffered from SD. Six months after initiation of treatment, none of the patient had stopped it due to efficacy or safety issues. All severity indices (SCORAD, EASI, VAS pruritus, and DLQI) had significantly improved by more than 50% from baseline. The improvement in the sexual dysfunction index had improved by four points, both in the male and female patients.
Many large population studies on SD in patients with moderate-to-severe atopic AD only focus on male gender and clinical diagnoses, rather than specific and validated questionnaires. Dupilumab treatment in patients with moderate-to-severe AD has shown a positive impact on the levels of SD in both male and female populations. Further studies focused on populations with mild atopic AD and with larger sample sizes are required to corroborate these preliminary results.
特应性皮炎是一种全身性和免疫介导的皮肤病，包括广泛的生理和心理合并症。在后者中，焦虑和抑郁的评估已经是许多研究的主题，但性性功能障碍（SD）在文献中很少被提及。本研究的目的是评估中重度特应性皮炎（AD）患者队列中 SD 的患病率，并确定度普利尤单抗治疗对其的可能影响。
进行了一项横断面研究。招募的患者于 2019 年 7 月 1 日至 2020 年 6 月 30 日在西班牙格拉纳达圣塞西莉亚大学医院皮肤科被诊断为中重度 AD，并进行了为期 6 个月的随访，在此期间测量了度普利尤单抗治疗的影响。研究的主要变量，性性功能障碍，根据性别进行了不同的评估。对于男性患者，应用国际勃起功能指数（IIEF-5），而对于女性患者，应用“女性性功能指数”问卷。
我们的研究包括 31 名患者，18 名男性和 13 名女性。男性的平均年龄为 35 +/- 14.55 岁，而女性的平均年龄为 33 +/- 10.46 岁。我们系列中 79%的患者（n=22）存在 SD，而 29%（n=9）没有。在我们抽样的男性中，66.9%（n=22）和女性中 76.9%（n=10）患有 SD。开始治疗 6 个月后，由于疗效或安全性问题，没有患者停止治疗。所有严重程度指数（SCORAD、EASI、VAS 瘙痒和 DLQI）均较基线改善超过 50%。男性和女性患者的性性功能障碍指数均改善了 4 分。
许多关于中重度特应性皮炎患者 SD 的大型人群研究仅关注男性性别和临床诊断，而不是特定和经过验证的问卷。度普利尤单抗治疗中重度 AD 患者对男性和女性人群的 SD 水平均有积极影响。需要进一步研究关注轻度特应性皮炎人群和更大样本量的人群，以证实这些初步结果。
