During my first flare-up, I did research into a potential link between tonsils and psoriasis. Later, while reading one of many books (The Keystone Approach) I was reminded of this:
Having read multiple explanations online, I broke the science down to get my head around it:
Streptococcal infections are caused in the throat tissue/tonsils by a type of bacteria (known as Streptococcus).
The tonsils are part of the immune system: they contain immune cells known as T cells which are supposed to only attack foreign cells- such as bacteria.
Psoriasis is an autoimmune condition: this means that it’s caused by an immune response (i.e. producing T cells) that attacks healthy cells.
Guttate psoriasis is triggered by the immune response to Streptococcus.
Strep infection -> immune response (producing T cells) -> these T cells attack healthy cells -> guttate psoriasis.
It’s therefore suggested that, if the tonsils are removed, there will be less T cells causing the self-damage that brings about psoriasis.
Although several websites do say that the tonsils play an important part of the immune system, the NHS says as you get older, the tonsils become less important in fighting germs and usually shrink. Your body can still fight germs without them.
Multiple scientific/medical journals backed this up, as did a doctor I spoke to during a virtual GP appointment in addition to the dermatologist I saw for my light therapy re-referral (she described a tonsillectomy in my situation as "not unsensible").
Tonsillectomies through the NHS are only for patients experiencing repeated tonsillitis. In other words, I needed to find a private provider. The procedure takes about 30 minutes and is done under general anaesthetic. Recovery time is around two weeks.
Given that a sore throat led to both of my psoriasis flare-ups, it all seems to point to the above. The specific form- guttate- is associated with streptococcal infections. In addition, I can safely discount all the other major potential triggers including stress, certain operations (e.g. hip replacement).
In relation to the second flare-up, it’s not like my diet was bad- just a little more indulgent than usual. I’ve never in my life been intolerant to potatoes, tomatoes, dairy etc. so it just doesn’t make sense that I’d suddenly become ‘allergic’ to them.
I will have no doubt spent hundreds of pounds on
psoriasis-related “remedies” by now. I drink horrible drinks, limit my diet to
a potentially pointless extent and undergo time-consuming moisturising
routines.
With this in mind, I arranged a consultation with Practice Plus Group down at their Bristol clinic. I was told that a tonsillectomy could be performed, but the anaesthetist would only be willing to do so once all my psoriasis was gone.
This wasn't the response I was expecting. Fortunately, my light therapy started soon after, and TO BE CONTINUED.
Strep Resources
A Comprehensive Textbook of Psoriasis | Tonsillectomy | P111
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