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Bedeutung von Streptokokken für die Psoriasispathogenese

The role of streptococci in psoriasis

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Zusammenfassung

Infektionen durch Streptococcus pyogenes spielen unter den Umweltfaktoren, die Erstmanifestationen oder Rezidive einer Psoriasis in prädisponierten Individuen auslösen, eine besondere Rolle. Streptokokkenangina und -pharyngitis, aber auch perianale streptogene Dermatitis, streptogene Vulvovaginitis und Balanoposthitis sind mögliche Ursachen. Verschiedene Mechanismen wie molekulare Mimikry oder Superantigene sind hieran beteiligt. Viele Patienten entwickeln eine chronische Streptokokkeninfektion oder -kolonisierung, die unter anderem durch die Fähigkeit der Streptokokken zur intrazellulären Aufnahme und Persistenz in Epithelzellen bedingt ist. Ob und unter welchen Bedingungen die kurative Behandlung einer Streptokokkeninfektionen durch Tonsillektomie oder antibiotische Therapie den Verlauf einer Psoriasis beeinflussen kann, wie verschiedene Beobachtungen vermuten lassen, muss noch durch kontrollierte Studien untersucht werden.

Abstract

Infections with Streptococcus pyogenes are highly relevant among the environmental factors that contribute to first onset or relapses of psoriasis in predisposed individuals. Streptococcal angina or pharyngitis, but also perianal streptococcal dermatitis, vulvovaginitis or balanoposthitis are potential causes. Several mechanisms such as molecular mimicry or superantigens may be involved. Many patients develop a chronic streptococcal infection or colonization that may result from the ability of streptococci for intracellular uptake and persistence in epithelial cells. Whether and under what conditions a curative treatment of streptococcal infection by tonsillectomy or antibiotic treatment may affect the course of psoriasis, as proposed by several observations, needs to be determined in more detail by clinical trials.

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  1. Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstraße 9–11, 80337, München, Deutschland

    J.C. Prinz

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Prinz, J. Bedeutung von Streptokokken für die Psoriasispathogenese. Hautarzt 60, 109–115 (2009). https://doi.org/10.1007/s00105-008-1661-5

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