BACKGROUND: Sexual life can be severely affected in patients with psoriasis. However, this component is not often assessed by clinicians. OBJECTIVE: To estimate the prevalence of sexual impairment and its degree of association with clinical and personal factors among psoriasis patients. METHODS: Sexual life impairment was investigated in all eligible adults hospitalized with psoriasis in a dermatological hospital from February 2000 to February 2002, using answers to specific items from two dermatology-specific questionnaires, and from two psoriasis-specific questionnaires. Clinical severity and psychological problems were also evaluated. The same questionnaires were collected a month after hospital discharge, to estimate changes from baseline. RESULTS: Of 936 patients,from 35.5% (Psoriasis Disability Index) to 71.3% (Impact of Psoriasis on Quality of Life Questionnaire) reported to have experienced sexual problems because of psoriasis. A more severe disease and the presence of psychological problems were also associated with sexual impairment. At 1-month follow-up, a reduction of >75% in clinical severity was associated with a twofold probability of substantial improvement of sexual life. CONCLUSIONS: Sexual impairment is very frequent in patients with psoriasis. Single questions on sexual life from quality of life questionnaires provide a simple tool that may be useful in clinical practice to assess sensitive issues, and thus to provide better patient-physician communication.