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Effect of tonsillectomy on psoriasis: A systematic review

Published:November 19, 2014DOI:https://doi.org/10.1016/j.jaad.2014.10.013

      Background

      Streptococcal infection is associated with psoriasis onset in some patients. Whether tonsillectomy decreases psoriasis symptoms requires a systematic review of the literature.

      Objective

      We sought to determine whether tonsillectomy reduces psoriasis severity through a comprehensive search of over 50 years of literature.

      Methods

      We searched MEDLINE, CINAHL, Cochrane, EMBASE, Web of Science, and OVID databases (from August 1, 1960, to September 12, 2013) and performed a manual search of selected references. We identified observational studies and clinical trials examining psoriasis after tonsillectomy.

      Results

      We included data from 20 articles from the last 53 years with 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 their psoriasis. Although some patients who underwent tonsillectomy experienced sustained improvement in psoriasis, others experienced psoriasis relapse after the procedure.

      Limitations

      Fifteen of 20 publications were case reports or series that lacked control groups. Publication bias favoring reporting improved cases needs to be considered.

      Conclusion

      Tonsillectomy may be a potential option for patients with recalcitrant psoriasis associated with episodes of tonsillitis. Studies with long-term follow-up are warranted to determine more clearly the extent and persistence of benefit of tonsillectomy in psoriasis.

      Key words

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      Linked Article

      • Is tonsillectomy a therapeutic option for plaque-type psoriasis?
        Journal of the American Academy of DermatologyVol. 73Issue 4
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          To the Editor: I read with interest the recent article by Rachakonda et al1 on the effect of tonsillectomy on psoriasis. The authors systematically reviewed previous papers and concluded that tonsillectomy may be a potential option for recalcitrant psoriasis patients with episodes of tonsillitis.
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