Kouno Michiyoshi, Nishiyama Akihiro, Minabe Masaki, Iguchi Naohiko, Ukichi Kenichiro, Nomura Takeshi, Katakura Akira, Takahashi Shinichi
Department of Dermatology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Department of Oral Medicine, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
J Dermatol. 2017 Jun;44(6):695-698. doi: 10.1111/1346-8138.13751. Epub 2017 Feb 2.
Both metal allergy and dental focal infection have been considered as causative factors for palmoplantar pustulosis, and several case reports described that the skin lesions were ameliorated after dental metal removal or dental infection control. However, limited data are available to evaluate the association of these factors with disease severity of palmoplantar pustulosis. This study is designed to analyze the clinical outcome of 85 palmoplantar pustulosis patients after dental infection control (n = 70), tonsillectomy (n = 6) and dental metal removal (n = 9). More than half of the patients (63%, 44/70) showed positive clinical outcome after dental infection control. The skin lesions of all patients with tonsillitis were improved after tonsillectomy (100%, 6/6). On the other hand, one-third of patients (33%, 3/9) showed positive response after dental metal removal. These results suggest that focal infection is more closely associated with palmoplantar pustulosis than dental metal allergy. According to our findings, palmoplantar pustulosis patients should be preferentially examined for focal infections.
金属过敏和牙源性局灶性感染均被认为是掌跖脓疱病的致病因素，有几例病例报告称，在去除牙齿金属或控制牙齿感染后，皮肤病变有所改善。然而，目前评估这些因素与掌跖脓疱病疾病严重程度之间关联的数据有限。本研究旨在分析85例掌跖脓疱病患者在控制牙齿感染（n = 70）、扁桃体切除（n = 6）和去除牙齿金属（n = 9）后的临床结果。超过一半的患者（63%，44/70）在控制牙齿感染后显示出阳性临床结果。所有扁桃体炎患者在扁桃体切除后皮肤病变均得到改善（100%，6/6）。另一方面，三分之一的患者（33%，3/9）在去除牙齿金属后显示出阳性反应。这些结果表明，局灶性感染与掌跖脓疱病的关联比牙齿金属过敏更为密切。根据我们的研究结果，掌跖脓疱病患者应优先检查是否存在局灶性感染。
