Among patients with psoriasis, up to 63% may develop genital psoriasis and 79% develop inverse psoriasis.

Patients with genital psoriasis often experience significant internalized stigma and physical distress, including sexual dysfunction.

Because of the sensitive nature of the skin surrounding genital and intertriginous areas, it is important to understand the benefits and side effects of different treatments for genital and inverse psoriasis.

The first-line recommended therapy is topical corticosteroids, topical calcineurin inhibitors, and topical vitamin D analogs. The second-line recommendations are topical coal tar preparations and topical PDE-4 inhibitors. For recalcitrant or severe cases of genital psoriasis, biologic and other systemic therapies are recommended, with the most data available for ixekizumab.

Currently, clinical trials are evaluating the efficacy and safety of apremilast (oral PDE-4 inhibitor) and guselkumab (IL-23 inhibitor) for the treatment of genital psoriasis.