2012
DOI: 10.4049/jimmunol.1102834
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Improvement of Psoriasis after Tonsillectomy Is Associated with a Decrease in the Frequency of Circulating T Cells That Recognize Streptococcal Determinants and Homologous Skin Determinants

Abstract: Exacerbation of chronic psoriasis can be associated with streptococcal throat infections, and T cells that respond to peptide sequences common to streptococcal M proteins and skin keratins have been detected in patients’ blood. To our knowledge, we have conducted the first blinded, prospective study to assess the impact of tonsillectomy on psoriasis. Twenty-nine patients with chronic psoriasis and history of exacerbation after sore throat were randomly assigned to tonsillectomy (n = 15) or control (n = 14) gro… Show more

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Cited by 105 publications
(103 citation statements)
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“…Tonsils were obtained through routine tonsillectomies at the National University Hospital, Reykjavik, Iceland or as part of a clinical trial for tonsillectomy as a treatment for psoriasis [19]. A complete medical history was gathered from the psoriasis patients.…”
Section: Study Cohort and Tissuesmentioning
confidence: 99%
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“…Tonsils were obtained through routine tonsillectomies at the National University Hospital, Reykjavik, Iceland or as part of a clinical trial for tonsillectomy as a treatment for psoriasis [19]. A complete medical history was gathered from the psoriasis patients.…”
Section: Study Cohort and Tissuesmentioning
confidence: 99%
“…Tonsillectomy appears to be beneficial for some psoriasis patients who have a history of skin disease exacerbation triggered by sore throat [15,19]. There is a strong correlation between disease improvement and a decline in the frequency of skin-homing T cells in the blood that recognize homologous peptides, present in both the streptococcal M protein and keratins in psoriatic skin [19].…”
Section: Introductionmentioning
confidence: 99%
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“…Antibiotics that will eradicate the microbe when given over a long interval will eradicate psoriasis as well [15]. The same is true for tonsillectomy in psoriasis; the results are nearly as dramatic as those given injectable penicillin over a considerable period of time [16]. The reason the antibiotics need to be administered for a lengthy time is very likely related to the internalization and biofilm formation.…”
Section: Psoriasis Treatment-comparing Current and Alternative (Antimmentioning
confidence: 91%
“…It seems apparent that streptococcus has the leading role in the production of psoriasis; why not eradicate it? This has been shown to be possible with antibiotics, such as penicillin, and with tonsillectomy [15,16]. Where psoriasis has been linked with metabolic syndrome, arthritis, and other maladies (much the same as rheumatic fever), it seems that eradicating the microbe would very likely eradicate these secondary diseases in like fashion [5].…”
Section: Ethical Challengesmentioning
confidence: 99%