title: Throat Infections are Associated with Exacerbation in a Substantial Proportion of Patients with Chronic Plaque Psoriasis.
abstract: Streptococcal throat infections are known to trigger or exacerbate psoriasis, and several studies support the benefit of tonsillectomy. To evaluate the potential of tonsillectomy as a treatment, we used a retrospective study-specific questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations. Our survey sampled 275 psoriasis patients. Of patients with plaque psoriasis, 42% reported sore throat-associated psoriasis exacerbations, and of patients with confirmed streptococcal infections, 72% reported aggravation. Notably, women and patients with early onset psoriasis were more likely to report psoriasis exacerbation after a sore throat (p < 0.001, p = 0.046, respectively). Other psoriasis aggravation factors were more common in patients with sore throat-associated exacerbations (p < 0.01). Of tonsillectomized patients, 49% reported subsequent improvement and had more frequent sore throat-associated aggravation of psoriasis than patients who did not improve after tonsillectomy (p = 0.015). These findings suggest a closer association between sore throats, streptococcal throat infections and plaque psoriasis than reported previously.
authors.affiliation: Department of Dermatology, Akademiska University Hospital, 75 185 Uppsala, Sweden. ragnahlin@gmail.com.
authors.forename: Ragna H
authors.initials: RH
authors.lastname: Thorleifsdottir
authors.forename: Jenna H
authors.initials: JH
authors.lastname: Eysteinsdóttir
authors.forename: Jón H
authors.initials: JH
authors.lastname: Olafsson
authors.forename: Martin I
authors.initials: MI
authors.lastname: Sigurdsson
authors.forename: Andrew
authors.initials: A
authors.lastname: Johnston
authors.forename: Helgi
authors.initials: H
authors.lastname: Valdimarsson
authors.forename: Bardur
authors.initials: B
authors.lastname: Sigurgeirsson
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010612:Pharyngitis / Q000382:microbiology* / Q000601:surgery; D011565:Psoriasis / Q000382:microbiology*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000150:complications* / Q000601:surgery; D011795:Surveys and Questionnaires; D014068:Tonsillectomy