TY - JOUR T1 - Streptococcal infection distinguishes different types of psoriasis JF - Journal of Medical Genetics JO - J Med Genet SP - 767 LP - 768 DO - 10.1136/jmg.39.10.767 VL - 39 IS - 10 AU - P Weisenseel AU - B Laumbacher AU - P Besgen AU - D Ludolph-Hauser AU - T Herzinger AU - M Roecken AU - R Wank AU - J C Prinz Y1 - 2002/10/01 UR - http://jmg.bmj.com/content/39/10/767.abstract N2 - Key points The link between streptococcal tonsillitis and first onset of psoriasis is well known. Here we show that streptococcal infection is confined to a particular subtype of non-pustular psoriasis, which is defined by early onset (≤40 years), a positive family history, and the HLA molecules Cw6, B13, or B57. This suggests distinct inherited immune response patterns to streptococcal antigens as a key to understanding the pathogenesis of psoriasis. Epidemiologically, the first manifestations of psoriasis are promoted by upper respiratory tract infections with Streptococcus pyogenes. Parallels to post-streptococcal disorders are obvious but still lack pathogenetic proof. Two types of non-pustular psoriasis, types I and II, can be distinguished according to age of onset, family history, and inheritance of certain HLA alleles. Here we show that only type I but not type II psoriasis is associated with streptococcal infection.Psoriasis vulgaris is a chronic inflammatory disease that affects 1.5-2% of people in western societies with severe and disabling inflammation of the skin and, occasionally, arthritis. It is currently regarded as an autoimmune-like disorder that is mediated by antigen specific activation of T cells in the skin of genetically predisposed subjects.1 A high incidence of streptococcal throat infections as the main trigger of first psoriasis exacerbation2,3 favours streptococcal antigens as causative agents that may induce cross reactive … ER -