Psoriasis is a chronic skin condition that has been shown to have both genetic and environmental features. Streptococcal infection has been associated with the onset of psoriasis. The palatine tonsils represent an environment within the body that is particularly susceptible to infection and is ideal for antigen sampling. It is considered that psoriasis may be induced due to a cross-reactive T-cell response involving streptococcal M proteins and keratin containing homologous peptides. Antibiotics and tonsillectomy have been used for the treatment of chronic plaque psoriasis and guttate psoriasis. More recently, the first randomized, controlled clinical trial of tonsillectomy was performed. Here, we review the accumulating evidence pertaining to antistreptococcal interventions and tonsillectomy, and further consider their efficacy as treatment options.
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