Hidradenitis Suppurativa Tanılı Hastalarda Cinsel Fonksiyon Bozukluğunun Değerlendirilmesi: Hastalığın Evresi ve Lezyon Yerleşim Yeri Cinsel Fonksiyonu Etkiliyor mu?
Yıl 2026,
Cilt: 48 Sayı: 1, 103 - 113, 15.12.2025
Tubanur Çetinarslan
,
Şule Yıldız Sağcan Tercan
,
Ali Can Albaz
,
Beyhan Özyurt
,
Aylin Türel Ermertcan
Öz
Hidradenitis süpürativa (HS), kıl folikülünün kronik, inflamatuar, tekrarlayan bir deri hastalığıdır. HS’nin hem kadın hem erkek bireylerde cinsel fonksiyonu bozduğuna dair literatürde yayınlar mevcuttur. Bu prospektif çalışmada HS’li kadın hastalarda cinsel fonksiyon bozukluğunun (seksüel disfonksiyon, SD) varlığı Kadın Cinsel İşlev Ölçeği (FSFI) kullanılarak, erkek hastalarda ise Uluslarası Erektil İşlev Formu (IIEF) kullanılarak araştırılmış ve sağlıklı kontrol grubu ile her iki cinsiyette ayrı olarak karşılaştırılmıştır. Çalışmaya toplam 46 hasta (30 erkek ve 16 kadın) ve 81 sağlıklı kontrol (44 erkek ve 37 kadın) dahil edildi. Kadın hastalarda SD %81.3 (n=13) hastada varken, kadın kontrol grubunda %29.7 (n=11) hastada vardı (p=0.001). HS tanılı kadın hastalarda, sağlıklı kadın kontrol grubuna kıyasla; cinsel istek (p<0.005), cinsel uyarılma (p<0.001), lubrikasyon (p=0.008), orgazm (p<0.001) ve memnuniyet (p<0.001) skorlarının tümünde anlamlı düşüklük saptandı. Erkek hastalarda SD %20.0 (n=6) hastada vardı. Erkek hastalarda SD gluteal bölgede tutulumu olanlarda olmayanlara göre anlamlı olarak daha fazla izlendi (p=0.005). Erkeklerde Hurley evresine göre bakıldığında; Hurley Evre 3 olanlarda cinsel istek diğer evrelere göre anlamlı olarak daha düşüktü (p=0.02). HS'li hastalarda cinsel yaşam sorunları sağlıklı bireylere göre oldukça sıktır. Çalışmamızda da SD’nin özellikle erkek hastalarda hastalığın şiddeti ve lezyon yerleşim yeri ile ilişkili olduğunu bulduk. Ayrıca çalışmamızda erkek hastalara kıyasla (%20) kadın hastalarda SD sıklığı (%81.3) sağlıklı kontrol grubuna göre (erkek kontrol grubunda 0%, kadın kontrol grubunda %29.7) daha fazlaydı. Bu durum kadınların fiziksel görünüme bağlı olarak davranışlarını değiştirme konusunda daha fazla baskı yaşayabilmeleri ve kadınlarda beden imajının cinsel yaşamla doğrudan bağlantısı olması ile açıklanabilir.
Etik Beyan
Çalışma Manisa Celal Bayar Üniversitesi Tıp Fakültesi Sağlık Bilimleri Etik Kurulu tarafından onaylanmıştır (04.01.2023 tarih ve 20.478.486/164 sayılı onay).
Destekleyen Kurum
Yazarlar bu çalışma için finansal destek almadıklarını beyan etmişlerdir.
Teşekkür
Yazarlar bu çalışma için finansal destek almadıklarını beyan etmişlerdir.
Kaynakça
-
1. Sabat R, Alavi A, Wolk K, Wortsman X, McGrath B, Garg A, Szepietowski JC. Hidradenitis suppurativa. Lancet. 2025 Feb 1;405(10476):420-438.
-
2. Molina-Leyva A, Cuenca-Barrales C. Pruritus and Malodour in Patients with Hidradenitis Suppurativa: Impact on Quality of Life and Clinical Features Associated with Symptom Severity. Dermatology (Basel, Switzerland). 2020;236(1):59-65.
-
3. Nguyen, T.v.; Damiani, G.; Orenstein, L.; Hamzavi, I.; Jemec, G. Hidradenitis suppurativa: An update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J. Eur. Acad. Dermatol. Venereol. 2021, 35, 50–61.
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4. Alikhan, A.; Lynch, P.J.; Eisen, D.B. Hidradenitis suppurativa: A comprehensive review. J. Am. Acad. Dermatol. 2009, 60, 539–561.
-
5. Ingram JR. The epidemiology of hidradenitis suppurativa. Br J Dermatol. 2020;183:990–8.
-
6. Garg A, Lavian J, Lin G, Strunk A, Alloo A. Incidence of hidradenitis suppurativa in the United States: a sex- and age-adjusted population analysis. J Am Acad Dermatol. 2017;77:118–22.
-
7. Schrader AMR, Deckers IE, van der Zee HH, Boer J, Prens EP. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014;71:460–7.
-
8. Naik HB, Paul M, Cohen SR, Alavi A, Suàrez-Fariñas M, Lowes MA. Distribution of self-reported Hidradenitis Suppurativa Age at Onset. JAMA Dermatol. 2019;155:971–3.
-
9. Pandey A. Essentials of hidradenitis suppurativa: a comprehensive review of diagnostic and treatment perspectives. Ann Med Surg (Lond). 2024;86:5304–13.
-
10. Riis PT, Ring HC, Themstrup L, Jemec GB. The role of androgens and estrogens in Hidradenitis Suppurativa - A systematic review. Acta Dermatovenerol Croat. 2016;24:239–49.
-
11. WHO Department of Reproductive Health and Research. Report of a technical consultation on sexual health. Geneva: WHO; 2006 (updated 16/03/2014; accesed December 29, 2018). Available at: http://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf?ua=1.
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12. Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Quality of life and sexual function in postmenopausal women. Journal of women & aging. 2018;30(4):299-309.
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13. Nusbaum MR, Hamilton C, Lenahan P. Chronic illness and sexual functioning. American family physician. 2003;67(2):347-354.
-
14. Hatzimouratidis, K.; Hatzichristou, D. Sexual dysfunctions: Classifications and definitions. J. Sex. Med. 2007, 4, 241–250.
-
15. Park SE, Ma E, Dagenet C, Aleshin MA, Holahan HM, Shi VY, Hsiao JL. Sexual Dysfunction in Chronic Urticaria: A Systematic Review. Dermatol Ther (Heidelb). 2025 Jan;15(1):31-44. doi: 10.1007/s13555-024-01319-5. Epub 2024 Dec 11.
-
16. Marella P, Lipner SR. Psoriasis Is Associated With Increased Risk of Psychiatric Disorders and Sexual Dysfunction in a Case-Control Study of 29,912 Patients. Dermatol Pract Concept. 2024 Oct 30;14(4):e2024256.
-
17. Rodríguez-Pozo JA, Montero-Vílchez T, Diaz Calvillo P, Sanabria de la Torre R, Ureña Paniego C, Ramirez-Muñoz A, Arias Santiago S. The Impact of Atopic Dermatitis on Sexual Function and Reproductive Desires in Women. Acta Derm Venereol. 2024 Jun 11;104:adv35107. doi: 10.2340/actadv.v104.35107.
-
18. McGuigan K, McGuigan CJ. Chronic skin disorders negatively impact women's quality of life and sexual function. Evid Based Nurs. 2019 Oct;22(4):114. doi: 10.1136/ebnurs-2018-103040.
-
19. Esmann S, Jemec GBE. Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta Derm Venereol. 2011;91:328–32.
-
20. Cuenca-Barrales C, Montero-Vilchez T, Krajewski PK, Szepietowski JC, Matusiak L, Arias-Santiago S, et al. Sexual dysfunction and quality of life in patients with Hidradenitis Suppurativa and their partners. Int J Environ Res Public Health. 2022;20:389.
-
21. Heidarian P, Jalali A, Ghasemianrad M, Jalali R, Ezzati E. Global prevalence of sexual dysfunction in women with skin diseases: a systematic review and meta-analysis. BMC Womens Health. 2025 Mar 6;25(1):101. doi: 10.1186/s12905-025-03625-2.
-
22. Dattolo A, Torres M, Frias-Toral E, Paganelli A, Zhang M, Madonna S, Mercurio L, Cucalón G, Garbarino F, Albanesi C, Scala E. Beyond the skin: endocrine, psychological and nutritional aspects in women with hidradenitis suppurativa. J Transl Med. 2025 Feb 10;23(1):167. doi: 10.1186/s12967-025-06175-1.
-
23. Caliezi A, Rabufetti A, Hunger R, Wolf R, Seyed Jafari SM. Impact of Hidradenitis Suppurativa on Sexual Quality of Life. J Clin Med. 2025 Jan 30;14(3):910. doi: 10.3390/jcm14030910.
-
24. Krajewski PK, Strobel A, Schultheis M, Staubach P, Grabbe S, Hennig K, Matusiak L, von Stebut E, Garcovich S, Bayer H, Heise M, Kirschner U, Nikolakis G, Szepietowski JC. Hidradenitis Suppurativa Is Associated with Severe Sexual Impairment. Dermatology. 2024;240(2):205-215. doi: 10.1159/000536128.
-
25. Varney P, Guo W, Brown M, Usmani H, Marquez J, Ayasse M, Kaufmann T, Haughton A. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol. 2023 Jun;62(6):737-746. doi: 10.1111/ijd.16328.
-
26. Smith AD, Curtin GP, Allen NC, Fernandez-Penas P, Varey AH. Management of genital hidradenitis suppurativa and lymphoedema with the restoration of erectile function. Australas J Dermatol. 2022 May;63(2):e184-e186. doi: 10.1111/ajd.13796. Epub 2022 Feb 9.
-
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Evaluation of Sexual Dysfunction in Patients with Hidradenitis Suppurativa: Do Disease Stage and Lesion Location Affect Sexual Function?
Yıl 2026,
Cilt: 48 Sayı: 1, 103 - 113, 15.12.2025
Tubanur Çetinarslan
,
Şule Yıldız Sağcan Tercan
,
Ali Can Albaz
,
Beyhan Özyurt
,
Aylin Türel Ermertcan
Öz
Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurrent skin disease of the hair follicle. HS disrupts sexual function in both women and men.In this prospective study, the presence of sexual dysfunction (SD) was investigated in female patients with HS using the Female Sexual Function Index (FSFI) and in male patients using the International Index of Erectile Function (IIEF). Both genders were compared with a healthy control group. A total of 46 patients (30 males and 16 females) and 81 healthy controls (44 males and 37 females) were included in the study. SD was present in 81.3% (n=13) of female patients, while it was present in 29.7% (n=11) of female controls (p=0.001). In female patients with HS compared to the healthy control group; significant decreases were found in sexual desire (p<0.005), sexual arousal (p<0.001), lubrication (p=0.008), orgasm (p<0.001), and satisfaction (p<0.001) scores. SD was present in 20.0% (n=6) of male patients. SD was significantly more common in male patients with involvement of the gluteal region than in those without (p=0.005). According to Hurley stage in males, sexual desire was significantly lower in Hurley stage 3 compared to other stages (p=0.02). Sexual life problems are quite common in patients with HS compared to healthy individuals. In our study, we found that SD was associated with disease severity and lesion location, particularly in male patients. Furthermore, the frequency of SD in female patients (81.3%) was higher in our study compared to the healthy control group (0% in the male control group and 29.7% in the female control group) compared to male patients (20%). This can be explained by the fact that women may experience more pressure to change their behavior based on physical appearance and that body image in women has a direct link to sexual life.
Etik Beyan
The study was approved by Manisa Celal Bayar University Faculty of Medicine Health Sciences Ethics Committee (approval dated 04.01.2023 and numbered 20.478.486/164).
Destekleyen Kurum
The authors declared that they received no financial support for this study.
Teşekkür
The authors declared that they received no financial support for this study.
Kaynakça
-
1. Sabat R, Alavi A, Wolk K, Wortsman X, McGrath B, Garg A, Szepietowski JC. Hidradenitis suppurativa. Lancet. 2025 Feb 1;405(10476):420-438.
-
2. Molina-Leyva A, Cuenca-Barrales C. Pruritus and Malodour in Patients with Hidradenitis Suppurativa: Impact on Quality of Life and Clinical Features Associated with Symptom Severity. Dermatology (Basel, Switzerland). 2020;236(1):59-65.
-
3. Nguyen, T.v.; Damiani, G.; Orenstein, L.; Hamzavi, I.; Jemec, G. Hidradenitis suppurativa: An update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J. Eur. Acad. Dermatol. Venereol. 2021, 35, 50–61.
-
4. Alikhan, A.; Lynch, P.J.; Eisen, D.B. Hidradenitis suppurativa: A comprehensive review. J. Am. Acad. Dermatol. 2009, 60, 539–561.
-
5. Ingram JR. The epidemiology of hidradenitis suppurativa. Br J Dermatol. 2020;183:990–8.
-
6. Garg A, Lavian J, Lin G, Strunk A, Alloo A. Incidence of hidradenitis suppurativa in the United States: a sex- and age-adjusted population analysis. J Am Acad Dermatol. 2017;77:118–22.
-
7. Schrader AMR, Deckers IE, van der Zee HH, Boer J, Prens EP. Hidradenitis suppurativa: a retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014;71:460–7.
-
8. Naik HB, Paul M, Cohen SR, Alavi A, Suàrez-Fariñas M, Lowes MA. Distribution of self-reported Hidradenitis Suppurativa Age at Onset. JAMA Dermatol. 2019;155:971–3.
-
9. Pandey A. Essentials of hidradenitis suppurativa: a comprehensive review of diagnostic and treatment perspectives. Ann Med Surg (Lond). 2024;86:5304–13.
-
10. Riis PT, Ring HC, Themstrup L, Jemec GB. The role of androgens and estrogens in Hidradenitis Suppurativa - A systematic review. Acta Dermatovenerol Croat. 2016;24:239–49.
-
11. WHO Department of Reproductive Health and Research. Report of a technical consultation on sexual health. Geneva: WHO; 2006 (updated 16/03/2014; accesed December 29, 2018). Available at: http://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf?ua=1.
-
12. Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Quality of life and sexual function in postmenopausal women. Journal of women & aging. 2018;30(4):299-309.
-
13. Nusbaum MR, Hamilton C, Lenahan P. Chronic illness and sexual functioning. American family physician. 2003;67(2):347-354.
-
14. Hatzimouratidis, K.; Hatzichristou, D. Sexual dysfunctions: Classifications and definitions. J. Sex. Med. 2007, 4, 241–250.
-
15. Park SE, Ma E, Dagenet C, Aleshin MA, Holahan HM, Shi VY, Hsiao JL. Sexual Dysfunction in Chronic Urticaria: A Systematic Review. Dermatol Ther (Heidelb). 2025 Jan;15(1):31-44. doi: 10.1007/s13555-024-01319-5. Epub 2024 Dec 11.
-
16. Marella P, Lipner SR. Psoriasis Is Associated With Increased Risk of Psychiatric Disorders and Sexual Dysfunction in a Case-Control Study of 29,912 Patients. Dermatol Pract Concept. 2024 Oct 30;14(4):e2024256.
-
17. Rodríguez-Pozo JA, Montero-Vílchez T, Diaz Calvillo P, Sanabria de la Torre R, Ureña Paniego C, Ramirez-Muñoz A, Arias Santiago S. The Impact of Atopic Dermatitis on Sexual Function and Reproductive Desires in Women. Acta Derm Venereol. 2024 Jun 11;104:adv35107. doi: 10.2340/actadv.v104.35107.
-
18. McGuigan K, McGuigan CJ. Chronic skin disorders negatively impact women's quality of life and sexual function. Evid Based Nurs. 2019 Oct;22(4):114. doi: 10.1136/ebnurs-2018-103040.
-
19. Esmann S, Jemec GBE. Psychosocial impact of hidradenitis suppurativa: a qualitative study. Acta Derm Venereol. 2011;91:328–32.
-
20. Cuenca-Barrales C, Montero-Vilchez T, Krajewski PK, Szepietowski JC, Matusiak L, Arias-Santiago S, et al. Sexual dysfunction and quality of life in patients with Hidradenitis Suppurativa and their partners. Int J Environ Res Public Health. 2022;20:389.
-
21. Heidarian P, Jalali A, Ghasemianrad M, Jalali R, Ezzati E. Global prevalence of sexual dysfunction in women with skin diseases: a systematic review and meta-analysis. BMC Womens Health. 2025 Mar 6;25(1):101. doi: 10.1186/s12905-025-03625-2.
-
22. Dattolo A, Torres M, Frias-Toral E, Paganelli A, Zhang M, Madonna S, Mercurio L, Cucalón G, Garbarino F, Albanesi C, Scala E. Beyond the skin: endocrine, psychological and nutritional aspects in women with hidradenitis suppurativa. J Transl Med. 2025 Feb 10;23(1):167. doi: 10.1186/s12967-025-06175-1.
-
23. Caliezi A, Rabufetti A, Hunger R, Wolf R, Seyed Jafari SM. Impact of Hidradenitis Suppurativa on Sexual Quality of Life. J Clin Med. 2025 Jan 30;14(3):910. doi: 10.3390/jcm14030910.
-
24. Krajewski PK, Strobel A, Schultheis M, Staubach P, Grabbe S, Hennig K, Matusiak L, von Stebut E, Garcovich S, Bayer H, Heise M, Kirschner U, Nikolakis G, Szepietowski JC. Hidradenitis Suppurativa Is Associated with Severe Sexual Impairment. Dermatology. 2024;240(2):205-215. doi: 10.1159/000536128.
-
25. Varney P, Guo W, Brown M, Usmani H, Marquez J, Ayasse M, Kaufmann T, Haughton A. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol. 2023 Jun;62(6):737-746. doi: 10.1111/ijd.16328.
-
26. Smith AD, Curtin GP, Allen NC, Fernandez-Penas P, Varey AH. Management of genital hidradenitis suppurativa and lymphoedema with the restoration of erectile function. Australas J Dermatol. 2022 May;63(2):e184-e186. doi: 10.1111/ajd.13796. Epub 2022 Feb 9.
-
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