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Deprecated: Implicit conversion from float 300.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Am+Acad+Dermatol 2016 ; 75 (5): 889-96 Nephropedia Template TP
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HLA-Cw6 homozygosity in plaque psoriasis is associated with streptococcal throat infections and pronounced improvement after tonsillectomy: A prospective case series #MMPMID27520394
J Am Acad Dermatol 2016[Nov]; 75 (5): 889-96 PMID27520394show ga
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: To evaluate whether HLA-Cw*0602 predicts a favourable outcome after tonsillectomy of psoriasis patients. Methods: This prospective case series followed 28 tonsillectomized patients with plaque psoriasis for 24 months. The Psoriasis Area and Severity Index (PASI), the Psoriasis Disability Index (PDI) and the Psoriasis Life Stress Inventory (PLSI) 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, PASI was reduced by 82% in the homozygous patients compared with 42% and 31% respectively (P < .001), PDI improved by 87% compared with 38% and 41% respectively (P < .001) and PLSI was 82% reduced compared with 60% and 54% respectively (P < .001). The homozygotes had more often 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 was retrospective. Conclusions: Homozygous HLA-Cw*0602 carriage in plaque psoriasis may predict a favourable outcome after tonsillectomy.