The role of focal infections in the pathogenesis of psoriasis and chronic urticaria

Abstract

IntroductionThe Focal Infection Theory, originally presented at the beginning of the 20th century, postulates that systemic diseases can be caused by microorganisms that arise from the focus of infection. Foci of infections have been described as sinuses, adenoids, tonsils, teeth, genitourinary tract, gall bladder and kidneys. A focus of infection is defined as the area that can occur in any part of the body, contains a pathogen (microorganism) and is usually asymptomatic. There are discordant opinions about the role of focal infections in the pathogenesis of psoriasis and urticaria.AimTo establish whether there is a higher incidence of focal infections in patients with chronic urticaria and psoriasis.Material and methodsWe retrospectively reviewed 129 patients with a history of psoriasis and chronic urticaria: 58 women and 71 men treated in the Department of Dermatology of the Jagiellonian University Medical College in Krakow.ResultsIn the analyzed group, 11 patients had a dental consultation, 58 – laryngological consultation and 29 women had a gynecological consultation. The most common examples of focal infection were tonsillitis, upper respiratory tract infections, sinusitis, dental caries and genitourinary tract infections. Aggravating factors were similar to previously described.ConclusionsA high incidence of focal infections in patients with psoriasis and urticaria suggests that infections may play a significant role in the pathogenesis of these skin disorders. Treatment of infection foci may play the key role in the remission of skin changes.

A cross sectional study on dental infections in chronic urticaria

“…Several studies have demonstrated an increased prevalence of oropharyngeal infections including dental infections, sinusitis and tonsillitis in patients with chronic urticaria. [8][9][10] In the present study evidence of dental infections were found in 42 cases (42%) of which 28 were males and 14 were females. 58% of the patients have no evidence of dental infections.…”

“…Both children and adults may develop urticaria, with the peak age of onset in adults being between 20 and 40 years. 2 In the present study, we have found a mean age group of 34 10 Whereas the study done by Sabroe et al showed a male predominance among 107 chronic idiopathic urticaria patients with a male to female ratio of 5:1.12. 7 in the present study we have found a male predominance with male to female ratio of 1.9:1 ( Figure 3).…”

IgA Nephropathy and Psoriatic Arthritis that Improved with Steroid Pulse Therapy and Mizoribine in Combination with Treatment for Chronic Tonsillitis and Epipharyngitis

“…It was recently reported that laryngological sources of infection are found in 44% of patients with psoriatic arthritis (15). Moreover, the effectiveness of cholecystectomy in removing the inflammatory focus as a treatment for psoriasis has also been reported (16).…”

Urticaria and bacterial infections

“…58 Several studies show an increased incidence of tonsillitis, sinusitis, and dental infections among patients with CU.…”

“…35 58 A pediatric study reported a positive throat culture in 8% of singleepisode AU and in 8% of recurrent AU and a positive urine culture in 6% of single-episode AU and in 6% of CU. 18 Other case reports described complete remission of CU after elimination of dental focal infections.…”