Animal model of focal tonsillar infection: human tonsillar lymphocytes induce skin lesion in SCID mice.

Based mainly on clinical evidence, a concept of focal tonsillar infections affecting certain skin diseases has been established. In such disorders as pustulosis palmaris et plantaris (PPP), there have been significant improvement of clinical manifestations following tonsillectomy. However, the pathophysiological mechanism of PPP due to focal tonsillar infections has not been made clear. In order to clarify the relationship between tonsil and PPP, an in vivo experimental model of this disease was developed by reconstituting severe combined immunodeficiency (SCID) mice with tonsillar lymphocytes (TL) from patients with PPP. The results can be summarized as follows: i) The SCID mice reconstituted with PPP-TL developed skin lesions with fur-loss and eruption around their cheek and forehead; ii) The reconstituted SCID mice showed long-term presence of human IgG in their sera, reaching maximum level at 6-8 weeks after the transfer; iii) Human anti-keratin antibody was found in the sera of reconstituted SCID mice reflecting that of the donors; iv) A section of the skin lesions showed thickened epidermis and blister formation. A few CD4(+) human lymphocytes were seen around the lesions, whereas CD8(+) lymphocytes and B cells were hardly seen; v) Human IgG deposits were observed in skin lesions of SCID mouse.