Patient-reported Outcomes and Clinical Response in Patients with Moderate-to-severe Plaque Psoriasis Treated with Tonsillectomy: A Randomized Controlled Trial

• Published in: Acta dermato-venereologica Vol. 97; no. 3; pp. 340 - 345
• Main Authors: Thorleifsdottir, Ragna Hlin, Sigurdardottir, Sigrun Laufey, Sigurgeirsson, Bardur, Olafsson, Jón Hjaltalin, Sigurdsson, Martin Ingi, Petersen, Hannes, Gudjonsson, Johann Eli, Johnston, Andrew, Valdimarsson, Helgi
• Format: Journal Article
• Language: English
• Published: Sweden 2017
• Subjects: Adult; chronic plaque psoriasis; Cost of Illness; Disability Evaluation; Female; health-related quality of life; Humans; Iceland; Male; Middle Aged; Patient Reported Outcome Measures; Psoriasis - diagnosis; Psoriasis - psychology; Psoriasis - surgery; Psoriasis Disability Index; Psoriasis Life Stress Inventory; Quality of Life; Remission Induction; Severity of Illness Index; streptococcal throat infection; Time Factors; tonsillectomy; Tonsillectomy - adverse effects; Treatment Outcome
• ISSN: 0001-5555; 1651-2057; 1651-2057
• DOI: 10.2340/00015555-2562

Psoriasis is a chronic inflammatory skin disease with profound effects on patients' health-related quality of life (HRQoL). Twenty-nine patients with plaque psoriasis and a history of streptococcal-associated psoriasis exacerbations were randomly assigned to tonsillectomy (n = 15) or control (n = 14) groups and followed for 24 months. Patients were evaluated with the Psoriasis Disability Index, Psoriasis Life Stress Inventory and Psoriasis Area and Severity Index. HRQoL and psoriasis-related stress improved significantly in the tonsillectomy group compared with the control group (p = 0.037 and p = 0.002, respectively), with a mean 50% improvement in HRQoL and a mean 59% improvement in psoriasis-induced stress. Clinical improvement correlated significantly with improved HRQoL (r = 0.297, p = 0.008) and psoriasis-related stress (r = 0.310, p = 0.005). Of the tonsillectomized patients, 87% concluded that the procedure was worthwhile. Tonsillectomy may improve quality of life for selected patients with plaque psoriasis.