Abstract
We examined patients with pustulosis palmaris et plantaris (PPP) which is a chronic relapsing skin disease characterized by sterile intraepidemal pustules and usually scaly erythematous skin on the palm, soles, or both. Aged 49 man with PPP had many dental treatments including restoration and crown using metal materials. No delayed type hypersensitivity against Pb was found by patch test, but Pd alloy contains Au, Ag, Cu and II. The aptitude test indicated that the Pd alloy did not match to the patient. The Bi-Digital O-Ring Test showed strong resonance of Hg. The patient stopped smoking and dental therapy in older to treat chronic infectious diseases such as periodontal disease was carried out. All restorative metals were removed and changed to composite resin material. Chinese parsely-100® (10mg × 4 times/day) was prescribed for 5 months. After these treatments, the PPP syndrome improved. Sixteen months later, the patients complained the relapsing. In the various examinations on the relapsing time, significantly high serum IgG antibody levels against Cytomegalo virus were found, but no increasing levels against Chlamydia pneumoniae or Mycoplasm pneumoniae. Systemic spreading of bacteria or their products from chronic oral infections has long been suspected to cause dermal diseases including PPP. Although it has been suggested that oral bacterial antigens, including heat shock proteins (Hsps), may be related to secondary disease, no clear evidence of the relationship between focal infections and Hsps has been shown. Serum IgG levels against Escherichia coli GroEL, a recombinant Dna J of Antinobacillous actinomycetemcomitans Hsp measured by ELISA and the relationship between the antibodies and PPP will he discussed.
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