Tonsillectomy may improve psoriasis symptoms in select patients

The causative link between chronic tonsillitis and psoriasis have been mostly speculative based on translational association studies.

Tonsillectomy may improve psoriasis symptoms in select patients
Tonsillectomy may improve psoriasis symptoms in select patients

Streptococcal pharyngitis is more common in patients with psoriasis, according to results of a retrospective study in the Journal of the American Academy of Dermatology.

“To our knowledge, this represents the most comprehensive systematic review on the effect of tonsillectomy on the clinical course of guttate and plaque psoriasis available to date,” noted by Tara D. Rachakonda, MD, MSCI, from the University of Utah, and colleagues.

This review included 20 observational studies and clinical trials from eight countries that examined psoriasis after tonsillectomy. These studies, conducted over the past 53 years, included 545 patients with psoriasis who were evaluated for or underwent tonsillectomy.

Of 410 reported cases of patients with psoriasis who underwent tonsillectomy, 290 experienced improvement in psoriasis symptoms. However, not all patients sustained improvement, and for this reason, tonsillectomy is not uniformly recommended for patients whose psoriasis has possible association to tonsillitis.

“In certain cases, the procedure may be reserved for selected patients with recalcitrant and recurrent psoriasis exacerbations clearly associated with chronic tonsillitis,” according to the study findings.

One limitation noted by the study authors was that 15 of 20 publications were case reports or series that lacked control groups.

“Publication bias favoring reporting improved cases needs to be considered,” wrote the researchers, adding that long-term follow-up studies are needed.

References

  1. Rachakonda TD. J Am Acad Dermatol. 2015; doi: http://dx.doi.org/10.1016/j.jaad.2014.10.013

Disclosures

Rachakonda has served as a subinvestigator for Amgen, Abbvie, and Lilly.

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