The Tonsil-Psoriasis Connection
Last updated: October 2019
I’m just going to come right out and say it-I have gigantic tonsils. Seriously. Like freaky large. So large that EVERY time I go to the doctor, they ask me if my throat hurts. EVERY time they want to check me for strep. To give you an idea, if you looked in my mouth right now, you would see my tonsils almost touching each other.
Weird, right? I always thought it was just another quirky part of my anatomy until I realized there is a connection between strep infections and psoriasis, specifically guttate. All of a sudden a lot of things made sense!
Strep throat is the worst!
As a kid, I battled strep throat and tonsillitis yearly. The bummer was that I always fell one infection “short” of the standard to recommend tonsil removal. I often wonder if my disease would have progressed to such a severe state had I gotten my tonsils removed early on. In one study, 86% of patients showed sustained improvement in their psoriasis after tonsillectomy1. Of course, now I am too old for that type of procedure, but there are always those “what ifs” that haunt me. Could a simple childhood surgery have saved me from decades of physical and emotional pain?
As an adult, I have gotten an annual dose of strep throat nearly every year. What’s more is that it always seems to come around the same time each year. It’s awful. Oh, is it awful! To start, it feels like I am swallowing pieces of glass. Then, the test for strep requires having a doctor take a super long Q-tip and swabbing the back of my throat (gag!) If that isn’t already bad enough, then finally my skin erupts in an angry red fury.
I’ve always had a mixture of plaque, guttate, and inverse psoriasis. When I am battling strep throat, the guttate really takes center stage. Want to freak someone out? Have a sore throat and red dots all over your body. No one wants to get near me when I am like that, and honestly, I don’t blame them. I look like Madam Mim at the end of The Sword and the Stone. The only silver lining is that a do get a temporary partial skin clearing when on antibiotics for the strep infection.
Infections as a trigger, symptom, or both?
This year was the first year in as long as I can remember that I haven’t had strep (knock on wood!) This makes me very curious as to if my biologic medication that is clearing my skin is also protecting me somehow from the bacterial throat infection. According to the side effect listed, I should be more susceptible to infections, but that is not what I have experienced so far.
Regardless, it has made me SUPER paranoid about strep. If anyone even mentions a tickle in their throat, I treat them like they have the plague. I recently found out one of my coworkers had been diagnosed with strep throat but continued to come to work. This got me fired up! I took the time to get on my soapbox to explain the fact he was putting others with compromised immune systems at risk.
When you have psoriasis the world seems full of triggers. If it isn’t an infection, it is food, or the weather, or medicine. I have learned to try my best to guard myself against the triggers I can and brace myself against the rest.
Does your psoriasis management change with the seasons?