Tonsil and pustulosis palmaris et plantaris. Mainly in respect of complement.

Abstract

Since the tonsil is one of the immunological organs, a concept whereby the relation between the tonsil and pustulosis palmaris et plantaris (hereafter abbreviated PPP) can be explained by a specific immunological mechanism, has been favoured. It must be pointed out, however, that there have been a considerable number of clinical findings which are irreconcilable with this concept. The present authors have therefore observed the relationship between the tonsil and PPP, from the point of view of non-specific in vivo factors, such as complements and endotoxins. This theory of the authors was motivated by the clinical fact that the serum complement titres of some patients with PPP were changed by performing the tonsillar provocation test, and that in such cases their skin rashes were aggravated after provocation. Thereafter, the distribution of the complemental components in the tonsillar tissue was examined with the immunofluorescence technique and it was found that they were localized mainly in the epithelium of the tonsillar crypt. In other words, the region where the complement system in the tonsillar tissue is active is the crypt. It was further found that the lacunar debris in the tonsillar crypt possesses a strong complement-activating activity. In particular, it was discovered that the action is stronger in bacteria and endotoxins within the lacunar debris. In recent years, the activation of complements associated with the surface layer of the skin has been emphatically considered to be the mechanism causing the onset of aseptic pustules in patients with PPP.(ABSTRACT TRUNCATED AT 250 WORDS)