皮膚科から見た掌蹠膿疱症と扁桃病巣感染症

抄録

It is widely accepted by otolaryngologists in Japan that the palatine tonsil is typically the site of focal infection in cases of pustulosis palmaris et plantaris (PPP). Numerous reports have indicated that about 80% of PPP cases are successfully treated by tonsillectomy. It is thus important to know how dermatologists treat PPP patients, especially in investigations of focal infection. Questionnaires were sent to 577 dermatologists in the Kinki district and 238 answers were analyzed. Dermatologists tended to treat PPP patients first with corticosteroid ointment and secondly with tonsillectomy. However the questionnaires revealed that tonsillectomy was performed on an average of 1.5 patients per year as treatment for PPP. Examination of focal infection, was carried out by about 70% of the dermatologists only in severe cases. Regarding the pathogenesis of PPP, 97% of the dermatologists agreed that PPP may be the result of tonsillar focal infection. However, almost all of them indicated that the percentage of patients in which the tonsil plays a role in the pathogenesis of PPP is less than 50%. The majority of dermatologists seem to feel that tonsillar focal infection plays a small part in the pathogenesis of PPP. On the basis of this study, it is stressed that we as otolaryngologists, should more clearly communicate the role of focal infections in dermatological disorders such as PPP and educate dermatologists regarding the very high curative rate of PPP by tonsillectomy.