Evaluation of tonsillectomy as a treatment for pustulosis palmaris et plantaris

Abstract

Two hundred and eighty five cases of pustulosis palmaris et plantaris (PPP), of which 73 cases (25.6%) underwent tonsillectomy, were studied to evaluate the effectiveness of tonsillectomy as a treatment for PPP. The group of tonsillectomized patients showed significantly better results than a group which received other methods of treatment. A tendency to leukocytosis was observed in PPP which normalized, in many cases, after tonsillectomy. The shorter the period between the onset of PPP and tonsillectomy the better the results, and the quicker the response. A transient worsening of PPP after tonsillectomy did not after the prognosis. In order to determine if tonsillectomy was indicated, an ultrashort wave direct provocation test was conducted in which ultrashort wave was applied to the tonsil. Leukocytosis and worsening of PPP after the test was considered as an indication for tonsillectomy. In some cases, there were considerable changes in plasma cortisol levels and NBT test values after the provocation test. Improvement of PPP after the Impretol test (one of the annulation tests) in which Impretol was injected into the tonsil, appears to support the focal infection origin of PPP in these cases. There is a possibility that the Impretol test could be used as a treatment for PPP.