title: Clinical outcome of tonsillectomy for palmoplantar pustulosis and etiological relationship between palmoplantar pustulosis and tonsils.
abstract: Palmoplantar pustulosis (PPP) is famous for causing typical tonsillar focal diseases. Clinical improvement of PPP rash after tonsillectomy was seen in 109 (94%) of 116 patients by subjective self-assessment, and 52 (88%) of 59 patients by objective Palmoplantar Pustulosis Area and Severity Index (PPPASI) scoring. Flow-cytometric analyses revealed that expression of activation markers (CD25 and HLA) class II increased on tonsillar T cells from PPP and IgAN patients. Moreover, expressions of skin-homing receptors (CLA and CCR6) increased on tonsillar T cells from PPP patients. In addition, the expressions were enhanced by stimulation of indigenous bacteria. Moreover, those expressions also increased in peripheral T cells, and decreased after tonsillectomy. Immunohistchemical analyses revealed that the ligands of those receptors (E-selectin and chemokine ligand 20) were expressed in lesions of skin. On the basis of our findings, migration of tonsillar T cells on which several homing receptors express by hyperimmune response against indigenous bacteria have a critical role in the pathogenesis of tonsillar focal diseases.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. miki@asahikawa-med.ac.jp
authors.forename: Miki
authors.initials: M
authors.lastname: Takahara
mesh_terms: D006801:Humans; D007111:Immunity, Cellular; D014066:Palatine Tonsil / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D011565:Psoriasis / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D012867:Skin / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*; D014068:Tonsillectomy; D014069:Tonsillitis / Q000150:complications* / Q000276:immunology / Q000601:surgery