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Genital Psoriasis — SCE Dermatology MCQ

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HardGenital DermatologyGenital PsoriasisSCE Dermatology

A patient with psoriasis has not volunteered genital symptoms, but treatment selection and quality of life may be affected. Why should the clinician ask directly and sensitively about genital involvement?

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Correct answer: C — Genital psoriasis is under-reported and materially affects treatment and quality of life

The best answer is “Genital psoriasis is under-reported and materially affects treatment and quality of life”. NICE recommends treatment matched to severity, high-impact sites, functional burden, comorbidity and prior response; narrowband UVB is a finite specialist option for plaque or guttate psoriasis that topical therapy cannot control. The alternatives “Genital psoriasis does not exist, after specialist assessment, when the full phenotype supports it”, “It is reported spontaneously, when the full phenotype supports it”, “GUM clinics manage genital dermatoses, within an appropriate UK pathway”, “Genital psoriasis is not clinically significant, after clinicopathological correlation, after specialist assessment” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations