Abstract
The presence of the stratum corneum on the human skin surface is essential for the body because of its barrier function, which prevents the loss of water from living tissue and the penetration of deleterious chemicals and pathogenic microorganisms from the environment. Moreover, the stratum corneum plays a vital role in maintaining skin surface softness and smoothness due to its water-holding capacity. However, there are skin diseases such as pustulosis palmaris et plantaris and psoriasis where the presence of the stratum corneum plays a role in the production of unique sterile subcorneal pustules. In these dermatoses, there are 2 steps regarding different inflammatory processes in lesional skin. The initial step is characterized by the infiltration of autoreactive T lymphocytes that release proinflammatory lymphokines, under the influence of which epidermal keratinocytes further produce various chemokines. The second step starts when there is extensive tissue damage that directly exposes the stratum corneum to the tissue fluids. Complement in the tissue fluids is activated on the surface of the stratum conreum via the alternative pathway to release C5a and induce neutrophil chemotaxis toward the lesional stratum corneum. Tonsillectomy is considered to be effective because it removes the chronic infectious foci, under the influence of which T lymphocytes are presumed to invade the skin.
