The most common type of psoriasis in the genital region is inverse psoriasis. This type of psoriasis first shows up as smooth, dry, red lesions. It usually lacks the scale associated with plaque psoriasis.
There are various regions of the genital area that can be affected by psoriasis:
The pubis is the region on males and females above the genitals. This area can be treated similarly to psoriasis on the scalp; however, use caution. Skin in the pubic region is more sensitive than the skin on the scalp.
Psoriasis on the upper thighs often consists of many small, round patches that are red and scaly. Psoriasis in between the thighs is easily irritated, especially if the thighs rub together you walk or run.
Creases between thigh and groin
Psoriasis generally appears as non-scaly and reddish-white in the creases between the thigh and groin. The skin may have fissures (cracks). People who are overweight or athletic may have an infection called intertrigo, which looks similar yeast infection in the folds of the skin.
Psoriasis of the vulva often appears as a smooth, non-scaly redness. Scratching this area may cause an infection, produce dryness, and result in thickening of the skin and further itching.
Genital psoriasis usually affects the outer skin of the vagina as psoriasis does not normally affect mucous membranes. In general, genital psoriasis does not affect the urethra.
Psoriasis of the penis may appear as many small, red patches on the glans, or shaft. The skin may be scaly or smooth and shiny. Genital psoriasis affects both circumcised and uncircumcised males.
Anus and surrounding skin
Psoriasis on or near the anus is red, non-scaly and prone to itchiness. Psoriasis in this area may be confused with yeast, infections, hemorrhoidal itching, and pinworm infestations. The presence of these conditions can complicate the treatment of psoriasis. Rectal examinations and skin cultures can confirm these conditions. Symptoms of anal psoriasis may include bleeding, pain during bowel movement, and excessive dryness and itching.
Psoriasis in the buttocks crease may be red and non-scaly or red with very heavy scales. The skin in this area is not as fragile as that of the groin.
Genital psoriasis generally responds well to treatment. Due to the sensitivity of genital skin, treatment requires special attention. Topicals and ultraviolet (UV) light are most often used. Doctors generally don’t prescribe systemic medications for genital psoriasis alone. However, they may if psoriasis is severe or resistant to topical therapy, or also appears on other parts of the body.