Tonsillectomy and the subsequent risk of psoriasis: A nationwide population-based cohort study

Published:February 03, 2021DOI:


      Tonsillectomy has been suggested as an intervention to resolve psoriasis.


      This study aimed to investigate the subsequent risk of psoriasis in patients who received tonsillectomy.


      We used data from the Taiwan National Health Insurance Research Database. The tonsillectomy group (case group) and the tonsillectomy-free group (comparison group) were matched at a ratio of 1:4 by demographic data, comorbidities, medical confounders, and the index date. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).


      We identified 2021 patients as the case group and matched 8084 individuals as the comparison group. The adjusted HR (aHR) of psoriasis was 0.43 (95% CI, 0.22-0.87; P < .05). The study population is composed of a mainly male (65%) and young population (mostly younger than 50 years). Notably, patients with rheumatoid arthritis increased the risk of psoriasis (aHR, 3.97; 95% CI, 1.17-13.48; P < .05). In our stratification analysis, the risk of psoriasis decreased in almost all subgroups.


      Our database did not include information on genome and the subtypes of psoriasis.


      Our study showed a decreased risk of psoriasis in the tonsillectomy group after adjustment for baseline characteristics, comorbidities, and medical confounders compared with the reference group.

      Key words

      Abbreviations used:

      aHR (adjusted hazard ratio), CI (confidence interval), GAS (group A Streptococcus), HR (hazard ratio), ICD-9-CM (International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Clinical Modification), LHIRD (Longitudinal Health Insurance Research Dataset), NHIRD (National Health Insurance Research Database)
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