Ragna H Thorleifsdottir1, Sigrun L Sigurdardottir2, Bardur Sigurgeirsson3, Jon H Olafsson3, Hannes Petersen4, Martin I Sigurdsson5, Johann E Gudjonsson6, Andrew Johnston6, Helgi Valdimarsson2. 1. Section of Dermatology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Immunology, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland; Department of Dermatology, Akademiska University Hospital, Uppsala, Sweden. Electronic address: ragnahlin@gmail.com. 2. Department of Immunology, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland. 3. Section of Dermatology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 4. Department of Otolaryngology-Head and Neck Surgery, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland. 5. Department of Anesthesiology and Critical Care, Landspitali-National University Hospital of Iceland, Reykjavik, Iceland. 6. Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan.
Abstract
BACKGROUND: Carriage of the HLA-Cw*0602 allele is associated with a particular set of clinical features and treatment responses in psoriasis. Tonsillectomy can improve psoriasis. OBJECTIVES: We sought to evaluate whether HLA-Cw*0602 predicts a favorable outcome after tonsillectomy of patients with psoriasis. METHODS: This prospective case series followed up 28 tonsillectomized patients with plaque psoriasis for 24 months. The Psoriasis Area and Severity Index, Psoriasis Disability Index, and Psoriasis Life Stress Inventory were used for assessment. Tonsils were swabbed for bacteria and patients genotyped for HLA-Cw*0602. RESULTS: After tonsillectomy, HLA-Cw*0602 homozygotes showed significantly more improvement, compared with heterozygous and HLA-Cw*0602-negative patients. Thus, Psoriasis Area and Severity Index score was reduced by 82% in the homozygous patients compared with 42% and 31%, respectively (P < .001), Psoriasis Disability Index score improved by 87% compared with 38% and 41%, respectively (P < .001), and Psoriasis Life Stress Inventory score was 82% reduced compared with 60% and 54%, respectively (P < .001). The homozygotes more often had psoriasis onset associated with a throat infection (P = .007) and an increased frequency of streptococcal throat infections per lifetime (P = .038). LIMITATIONS: Few patients were included and some data were retrospective. CONCLUSIONS: Homozygous HLA-Cw*0602 carriage in plaque psoriasis may predict a favorable outcome after tonsillectomy.
BACKGROUND: Carriage of the HLA-Cw*0602 allele is associated with a particular set of clinical features and treatment responses in psoriasis. Tonsillectomy can improve psoriasis. OBJECTIVES: We sought to evaluate whether HLA-Cw*0602 predicts a favorable outcome after tonsillectomy of patients with psoriasis. METHODS: This prospective case series followed up 28 tonsillectomized patients with plaque psoriasis for 24 months. The Psoriasis Area and Severity Index, Psoriasis Disability Index, and Psoriasis Life Stress Inventory were used for assessment. Tonsils were swabbed for bacteria and patients genotyped for HLA-Cw*0602. RESULTS: After tonsillectomy, HLA-Cw*0602 homozygotes showed significantly more improvement, compared with heterozygous and HLA-Cw*0602-negative patients. Thus, Psoriasis Area and Severity Index score was reduced by 82% in the homozygous patients compared with 42% and 31%, respectively (P < .001), Psoriasis Disability Index score improved by 87% compared with 38% and 41%, respectively (P < .001), and Psoriasis Life Stress Inventory score was 82% reduced compared with 60% and 54%, respectively (P < .001). The homozygotes more often had psoriasis onset associated with a throat infection (P = .007) and an increased frequency of streptococcal throat infections per lifetime (P = .038). LIMITATIONS: Few patients were included and some data were retrospective. CONCLUSIONS: Homozygous HLA-Cw*0602 carriage in plaque psoriasis may predict a favorable outcome after tonsillectomy.
Authors: C Enerbäck; T Martinsson; A Inerot; J Wahlström; F Enlund; M Yhr; L Samuelsson; G Swanbeck Journal: J Invest Dermatol Date: 1997-11 Impact factor: 8.551
Authors: Ragna H Thorleifsdottir; Jenna H Eysteinsdóttir; Jón H Olafsson; Martin I Sigurdsson; Andrew Johnston; Helgi Valdimarsson; Bardur Sigurgeirsson Journal: Acta Derm Venereol Date: 2016-08-23 Impact factor: 4.437
Authors: Helgi Valdimarsson; Ragna H Thorleifsdottir; Sigrun L Sigurdardottir; Johann E Gudjonsson; Andrew Johnston Journal: Trends Immunol Date: 2009-09-24 Impact factor: 16.687
Authors: Karita Haapasalo; Lotta L E Koskinen; Jari Suvilehto; Pekka Jousilahti; Annika Wolin; Sari Suomela; Richard Trembath; Jonathan Barker; Jaana Vuopio; Juha Kere; T Sakari Jokiranta; Päivi Saavalainen Journal: Infect Immun Date: 2018-09-21 Impact factor: 3.441