title: Chronic plaque psoriasis: streptococcus pyogenes throat carriage rate and therapeutic response to oral antibiotics in comparison with oral methotrexate.
abstract: OBJECTIVE
  To determine the throat carriage rate of Streptococcus pyogenes in patients having chronic plaque psoriasis and the effect of antibiotics as compared with that of oral methotrexate.
  
  
  METHODS
  Quasi-experimental study.
  
  
  METHODS
  Dermatology Department, Combined Military Hospital, Abbottabad, from January to December 2006.
  
  
  METHODS
  Forty patients and 40 age and gender-matched controls were selected. Throat swab for culture of Streptococcus pyogenes was taken from each patient and control. All patients were treated with oral Penicillin V 250 mg, 6 hourly, and oral Rifampicin, 600 mg daily, for 10 days. Pre- and posttherapy 'Psoriasis Area and Severity Index' (PASI) were compared. Thirty of these 40 patients were later given oral methotrexate, 5-10 mg weekly, for 04 weeks and pre- and post-therapy PASI were compared. Chi-square and paired-samples t-test were used for data analysis.
  
  
  RESULTS
  Throat swab cultures were positive for Streptococcus pyogenes in 05 (12.5%) patients and none (0%) of the controls (p=0.02). Mean pre- and postantibiotic therapy PASI were 15.92 +/- 05.94 and 15.19 +/- 06.17 respectively (p=0.078). Mean pre- and postmethotrexate PASI were 15.81 +/- 5.55 and 8.79 +/- 4.19 respectively (p < 0.01).
  
  
  CONCLUSIONS
  Throat carriage of Streptococcus pyogenes is common in patients with chronic plaque psoriasis. Short-term antibiotic treatment has no role in routine treatment of chronic plaque psoriasis. However, it would be worthwhile to consider the effects of long-term antibiotics on chronic plaque psoriasis.
authors.affiliation: Department of Dermatology, PAF Hospital Faisal, Karachi.
authors.forename: Naeem
authors.initials: N
authors.lastname: Raza
authors.forename: Muhammad
authors.initials: M
authors.lastname: Usman
authors.forename: Ahsan
authors.initials: A
authors.lastname: Hameed