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  • Title: Clinical outcome of tonsillectomy for palmoplantar pustulosis and etiological relationship between palmoplantar pustulosis and tonsils.
    Author: Takahara M.
    Journal: Adv Otorhinolaryngol; 2011; 72():86-8. PubMed ID: 21865698.
    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.
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