Journal of Clinical & Experimental Dermatology Research
Open Access

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

2^nd International Conference on Clinical Research Cardiology, Ophthalmology & Dermatology

5-7 March 2012 Omaha Marriott, USA

Helgi Valdimarsson, Ragna Hlin Thorleifsdottir, Sigrun Laufey Sigurdardottir, Bardur Sigurgeirsson, Jon Hjaltalin Olafsson, Martin Ingi Sigurdsson, Hannes Petersen, Sigurlaug Arnadottir, Johann Eli Gudjonsson and Andrew Johnston

Accepted Abstracts: J Clin Exp Dermatol Res

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. For the first time we have conducted a 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) groups and monitored for 2 years clinically and by enumeration of circulating skin homing T cells that respond to short homologous M-protein or keratin peptides. Thirteen patients (86%) showed sustained improvement after tonsillectomy ranging from 30 to 90% reduction in disease severity. Furthermore, there was a close correlation between the degree of clinical improvement in individual patients and reduction in the frequency of peptide- reactive skin-homing T cells in their circulation. No corresponding clinical or immunologic changes were observed amongst the controls. These findings indicate that tonsillectomy may have beneficial effect on chronic psoriasis because the palatine tonsils generate effector T cells that recognize keratin determinants in the skin.