Patient-reported Outcomes and Clinical Response in Patients with Moderate-to-severe Plaque Psoriasis Treated with Tonsillectomy: A Randomized Controlled Trial.
Psoriasis is a chronic inflammatory skin disease with profound effects on patients' health-related quality of life (HRQoL). Twenty-nine patients with plaque psoriasis and a history of streptococcal-associated psoriasis exacerbations were randomly assigned to tonsillectomy (n = 15) or control (n = 14) groups and followed for 24 months. Patients were evaluated with the Psoriasis Disability Index, Psoriasis Life Stress Inventory and Psoriasis Area and Severity Index. HRQoL and psoriasis-related stress improved significantly in the tonsillectomy group compared with the control group (p = 0.037 and p = 0.002, respectively), with a mean 50% improvement in HRQoL and a mean 59% improvement in psoriasis-induced stress. Clinical improvement correlated significantly with improved HRQoL (r = 0.297, p = 0.008) and psoriasis-related stress (r = 0.310, p = 0.005). Of the tonsillectomized patients, 87% concluded that the procedure was worthwhile. Tonsillectomy may improve quality of life for selected patients with plaque psoriasis.
Department of Medical Sciences, Dermatology, Uppsala University, SE-751 85 Uppsala, Sweden. ragnahlin@gmail.com.
Ragna Hlin
RH
Thorleifsdottir
Sigrun Laufey
SL
Sigurdardottir
Bardur
B
Sigurgeirsson
Jón Hjaltalin
JH
Olafsson
Martin Ingi
MI
Sigurdsson
Hannes
H
Petersen
Johann Eli
JE
Gudjonsson
Andrew
A
Johnston
Helgi
H
Valdimarsson
D000328:Adult; D017281:Cost of Illness; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007055:Iceland; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011565:Psoriasis / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects; D016896:Treatment Outcome