Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to clarify the relationship between bacterial flora in tonsillar lacunae and antistreptococcal antibody in sera of the patients with pustulosis palmaris et plantaris (PPP). Since the pustules develops or worsens after tonsillitis in many patients with PPP, a pathogenic role of tonsillar bacteria is suggested, but no significant association has been proven so far. In this study, the aerobes in the tonsillar lacunae were identified and quantitated in 15 adult patients with PPP and 9 adult patients with chronic tonsillitis (CT). In addition, serum streptococcal antigen-specific antibody levels in 40 adult patients with PPP, 18 adult patients with chronic tonsillitis, and 11 healthy volunteers (controls) were examined by enzyme-linked immunosorbent assay (ELISA). The results were as follows. 1. A total of 53 strains (17 species) of aerobes were isolated and identified from the tonsillar lacunae in patients with PPP, while 35 strains (12 species) of aerobes were found in the patients with CT. 2. S. salivarius and S. pneumoniae were the dominant aerobes isolated from patients with PPP or CT. 3. Although the rates of isolation for Staphylococcus and S. pneumoniae were lower in PPP patients than in CT patients, the rate for S. sanguis I was higher in PPP patients than in CT patients. 4. The percentage of alpha, gamma-streptococci to total aerobes in PPP patients was higher than in CT patients. 5. The IgG antibody titers against S. sanguis and S. mitis, and the IgM antibody titers against all streptococci investigated in PPP patients were higher than those in both CT patients and controls. 6. Moreover, both the IgG antibody titers against S. pyogenes T4 and S. sanguis I and the IgM antibody titers against S. sanguis I and S. sanguis II of the patients in which PPP markedly improved after tonsillectomy were higher than those in which PPP showed less improvement postoperatively.
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PMID:[Investigation of the bacterial flora in the tonsillar lacunae and serum levels of streptococcal antigen-specific antibodies in patients with pustulosis palmaris et plantaris]. 238 34

In clarification of the cause of Pustulosis palmaris et plantaris caused by tonsillar infection 19 patients with this condition and undergoing tonsillectomy were studied. IgE levels in the tonsils and blood serum were estimated both before and after tonsillectomy including various other laboratory tests. These results and the therapeutic effects of the tonsillectomy were analysed. 42 patients with tonsillitis undergoing tonsillectomy were used as controls. Lowered serum complement (C3) titres and decrease in neutrophil counts and serum IgG levels were observed in those patients whose cutaneous lesions were either completely or greatly improved following tonsillectomy. As neither the IgE levels in the tonsils nor in the serum were altered after tonsillectomy, the possibility of IgE mediated allergic type I reaction, as previously proposed by the present authors, was ruled out, and the aetiology was assessed to be an infectious allergy based on the Arthus reaction classified in the type III reaction.
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PMID:[An aetiological study on pustulosis palmaris et plantaris due to tonsillar focal infection (author's transl)]. 645 Jul 38

We studied the effects of tonsillectomy in patients with pustulosis palmaris et plantaris (PPP) and suspected of having focal tonsillar infections which could still be observed more than one year after tonsillectomy. The rate of healing with tonsillectomy, including 6 cases with remarkable effect, was 76%. The clinical findings from which we expect an effect of tonsillectomy are (a) late onset PPP and early tonsillectomy, (b) tonsils with grade I hypertrophy, oozing of pus, and localized dark-redness on the anterior palatine arches, (c) anamnestic tonsillitis, and (d) positive results both at tonsillar provocation and negation tests. From the analyses of pre- and postoperative clinical examinations we found that the preoperative values of serum complement (C3), and neutrophils, lymphocytes and eosinophils in peripheral blood were significantly depressed in the effectively treated group, compared with the 'ineffective' group or the control group.
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PMID:Pustulosis palmaris et plantaris due to tonsillar focal infections. From the analysis of long-term observed cases. 658 56

In recent years, Pustulosis palmaris et plantaris (PPP) has been described as one of the representative second lesions of focal tonsillitis in Japan. We selected 289 cases of PPP, treated with bilateral tonsillectomy at our department over the past 12 years for this clinical evaluation. In 211 of those 289 tonsillectomy cases, follow-up was done for more than 3 months after operation. Prior to tonsillectomy, 196 cases suffered from PPP only, 90 cases had the complication of osteo-arthral lesions such as sterno-costa-clavicular hyperosteosis (SCCH), rheumatoid arthritis, and soon, whereas only 3 cases showed simultaneous lesions of Psoriasis vulgaris. The efficacy of tonsillectomy for improving the skin lesions was classified into 6 grades, mainly based upon individual evaluation by each patient as follows; disappeared, remarkably improved, improved, slightly improved, unchanged, and worsened. According to our 211 cases, post tonsillectomy improvement of skin lesions was very obvious, with disappearance occurring in 54.3% of cases and remarkable improvement in 21.4%. Age of onset and the duration from onset to tonsillectomy showed no association with effectiveness. However, the shorter the duration from onset to tonsillectomy, the fewer days were required for improvement of the skin lesions. The rate of improvement of PPP rose in conjunction with the number of days after tonsillectomy. We conclude that it requires 12 months, at minimum, to determine the efficacy of tonsillectomy as a treatment for PPP.
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PMID:[Efficacy of tonsillectomy for improving skin lesions of Pustulosis palmaris et plantaris--evaluation of 289 cases at the Department of Otolaryngology of Sapporo Medical University]. 796 76

The morphological expression of the immune response of palatine tonsils obtained from patients with pustulosis palmaris et plantaris (PPP) was investigated by morphometry in conjunction with immunohistochemistry. First, to differentiate the histological features of tonsils between PPP and habitual tonsillitis, each extent of the T cell dependent areas (T nodules), B cell dependent areas (lymph follicles), germinal centers, mixed areas of T cells and B cells, and lacunar epithelium was measured and compared on 38 patients with PPP and 47 with habitual tonsillitis, respectively. The most remarkable findings in PPP were enlargement of the secondary T nodules, and atrophy of the lymph follicles with a decrease in number of the germinal center cells and fibrosis. These changes of lymph follicles were similar to those in the older patients with habitual tonsillitis, which suggests the intensely advanced stage of the immune response within the tonsils. Second, the histological structures of the tonsils of 15 tonsillectomy effective cases (88.2%) was compared with those of two non-effective cases in curing skin lesions. The histological structure in the non-effective cases was very similar to that in habitual tonsillitis cases. This indicates that the histological findings may be useful in predicting the effects of tonsillectomy on PPP.
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PMID:Histological features of palatine tonsils in pustulosis palmaris et plantaris: a morphometric study. 802 60

Clinical data, including focal infection and habitual cigarette smoking, were obtained from 203 male patients with pustulosis palmaris et plantaris (PPP) (age: 43.3 +/- 13.4) and 266 female patients (age: 44.0 +/- 13.7) for the 20 years from 1975 through 1994 to evaluate the relationship between the onset or severity of PPP and smoking. Seasonal incidences of onset were also studied. The incidence of onset of PPP symptoms was highest in June, when it is the most humid in Japan, and lowest in December. The most common infectious disease associated with PPP was tonsillitis. The percentages of heavy smoking (more than 20 cigarettes per day) were 74.7% and 32.9% for male and female patients, while those in the normal control population in Japan were 37.2% and 9.8% for males and females. These results suggest that heavy smoking, tonsillitis, and seasonal factors such as high humidity and high temperature may be related to the onset and exacerbation of PPP.
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PMID:The relationships of onset and exacerbation of pustulosis palmaris et plantaris to smoking and focal infections. 864

Pustulosis palmaris et plantaris (PPP) is known to be a skin disease related to tonsillitis, because the pustulosis often become exacerbated during acute tonsillitis and disappears after tonsillectomy. However, etiology of PPP remains unclear. In this study, we investigated the activation of tonsillar T-cell from PPP patients. Furthermore, we analyzed expressions of cytotoxic T-lymphocyte antigen-4 (CTLA4) that is a co-stimulatory molecule for inhibition of T-cell activation and of Smad7 that is a regulatory factor of TGF-beta intracellular signaling. For 47 Japanese patients with PPP who had tonsillectomy, the skin lesion was improved in 87% of PPP patient at 12 months after tonsillectomy. In quantitative immunohistologic analysis, T-cell nodules on tonsillar tissues from PPP patients were more expanded than those from the patients with obstructive sleep apnea syndrome (OSAS) (P = 0.015), and there was a positive correlation between the enlargement and clinical improvement (r = 0.422, P = 0.021). Flow cytometric analysis showed that the numbers of CD4+CD25+ and CD4+CD29+ cells in tonsils from PPP patients increased significantly compared to those from OSAS patients (P = 0.017, P = 0.016, respectively). Using reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analyses with CD3+ tonsillar lymphocytes, we found that both expressions of Smad7 mRNA and protein were enhanced in PPP patients compared with OSAS patients (P = 0.03, P = 0.02, respectively), but expression of TGF-beta mRNA was not different between 2 groups. Although mRNA expression of CTLA4 was reduced in PPP patients compared with OSAS patients (P = 0.04), the CTLA4 surface protein expression was not different between 2 groups. These data suggest that helper T-cells are frequently activated in tonsils from PPP patients, and this activation may be related to unresponsiveness of TGF-beta1 by overexpression of Smad7. Such hyper-activation of T-cell may increase the risk of elicitation of self-reactive T-cell, being associated with pathogenesis of PPP.
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PMID:Increase of activated T-cells and up-regulation of Smad7 without elevation of TGF-beta expression in tonsils from patients with pustulosis palmaris et plantaris. 1588 43

Palmoplantar pustulosis (PPP) is a chronic inflammatory disorder characterized by sterile pustules predominantly involving the palms and soles of middle-aged women. In contrast, regions other than the palms and soles are occasionally affected, manifesting scaly erythemas which resemble psoriasis, and solitary pustules are also seen. Some of these extra-palmoplantar lesions are induced by the Koebner phenomenon or occur after focal infections like tonsillitis. The tenderness and inflammation of the extra-palmoplantar lesions in PPP are milder than in psoriasis. Histological features show mild acanthosis of the epidermis with parakeratosis and mild infiltration of inflammatory cells in the upper dermis. On the other hand, severe pustular lesions are occasionally seen in the palms and soles of the patients with pustular psoriasis. These findings suggest a close relationship between PPP and psoriasis; however, different genetic, environmental, and immunological factors are likely to be involved. Recently, understanding of psoriasis pathophysiology has greatly progressed, and the concept of psoriasis pathogenesis is currently viewed as complicated responses between infiltrating leucocytes and the resident skin, via a number of inflammatory cytokines, chemokines, and mediators produced in the skin under regulation of cellular immune systems. By contrast, the pathogenesis of PPP has been poorly investigated. This paper reviews findings of the clinicopathophysiology of PPP, making a focus on the extra-palmoplantar lesions.
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PMID:Extra-palmoplantar lesions associated with palmoplantar pustulosis. 1945 7

Palmoplantar pustulosis (PPP) is a chronic inflammatory disorder characterized by sterile pustules predominantly involving the palms and soles of middle-aged women. Whether PPP is the acral type of pustular psoriasis or a distinct entity has long been discussed; however, the clinical features of PPP are really heterogeneous and different between Asians and Caucasians, which may depend on the race with backgrounds of different HLAs. PPP is closely related with psoriasis, but considered to be a distinct entity in Japan. Although the pathogenesis of PPP is still poorly understood, PPP is a representative skin disorder showing a close relationship with focal infections such as tonsillitis, chronic sinusitis, and dental infection. In particular, tonsillitis often triggers or deteriorates PPP. In Japanese patients, regions other than the palms and soles are occasionally affected manifesting scaly erythemas which resemble psoriasis, and solitary pustules are also seen. Some of these extra-palmoplantar lesions are induced by the Koebner phenomenon or occur after focal infections. Further, arthralgia is also induced on the sternum, clavics, sacroiliac joints, and upper ribs following focal infections. This paper makes a focus on the triggering role of focal infection in the induction of extra-palmoplantar lesions as well as arthralgia (putulotic arthro-osteitis).
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PMID:Triggering role of focal infection in the induction of extra-palmoplantar lesions and pustulotic arthro-osteitis associated with palmoplantar pustulosis. 2186 99

Palmoplantar pustulosis (PPP) is a chronic inflammatory disorder characterized by sterile pustules predominantly involving the palms and soles of middle-aged women. PPP frequently develops or exacerbates following focal infections, such as tonsillitis, odontogenic infection and sinusitis, either with or without arthralgia and/or extra-palmoplantar lesions. Pustulotic arthro-osteitis (PAO) is a joint comorbidity of PPP, most often affecting the anterior chest wall. PAO is sometimes regarded as the same entity as synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome, and may be a subtype or incomplete type of SAPHO syndrome; however, there are several differences. In Japanese patients, PPP with PAO is frequently seen, whereas SAPHO syndrome in the true meaning is rare. A difference of incidence depending on race suggests that different genetic backgrounds may be responsible for susceptibility to these disorders. Bacterial infection, especially Propionibacterium acnes, is suggested to play an important role in the pathogenesis of SAPHO syndrome. P. acnes is responsible for acne, however, bacterium is unassociated with PPP skin lesions which are characterized by sterile pustules. On the other hand, PAO is frequently triggered by focal infection, and treatment of focal infection results in dramatic effects on the release of joint pain. This paper reviews current insights into the clinicopathophysiology of PAO, and discusses its possible mechanisms in comparison with SAPHO syndrome.
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PMID:Pustulotic arthro-osteitis associated with palmoplantar pustulosis. 2412 44


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