Streptococcus pyogenes in Psoriasis

Streptococcal throat infections are known to trigger or exacerbate psoriasis. Strep throat can resolve, but the bacteria Streptococcus has the potential to colonize one's gut when ingested. This colonization may, in turn, trigger an autoimmune response leading to the development or exacerbation of psoriasis.

The Cause of Psoriasis:  Strep pyogenes?

Dr Haines Ely, a board certified dermatologist from UC Davis who studied the cause of psoriasis for 45 years thought the cause of psoriasis was in the gut. In 2018, his journal article, "Is psoriasis a bowel disease? Successful treatment with bile acids and bioflavonoids suggests it is," astounded researchers and clinicians worldwide.

Dr Ely explained that psoriasis is “the dysregulation of the gut-liver-skin axis and is caused by the absorption of bacterial byproducts through dysbiosis and a leaky gut, resulting in the skin shedding the toxins the psoriatic liver cannot handle.” Perhaps most importantly, what he states in his summary: "Pathogens, including Helicobacter pylori and Streptococcus pyogenes, must be eliminated with antimicrobial therapy for any treatment to work"

You can listen to Dr. Haines Ely in this interview. 

"Strep" throat infections, specifically caused by group A streptococcus (Streptococcus pyogenes), have been associated with plaque and guttate psoriasis.

• Plaque psoriasis: Plaque psoriasis is the most common form of psoriasis, accounting for approximately 80-90% of cases. It is characterized by the development of thick, raised, red patches of skin covered with silvery scales.

• Guttate  psoriasis: Guttate psoriasis is a subtype of psoriasis characterized by small, red, scaly spots that can appear suddenly on the skin.
  
  

Study on Sore Throat-Associated Psoriasis Exacerbations

In a study, by ActaDV, 275 psoriasis patients were recruited, 127 males and 148 females, to complete a study questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations.

75% had been diagnosed with plaque psoriasis, 14% with both guttate and plaque psoriasis and 8% percent with guttate psoriasis.

Out of those participants: 

Streptococcus and Gut Colonization in Psoriasis

While your Strep throat can resolve, the bacterium Streptococcus has the potential to colonize your gut when ingested, which may in turn trigger an autoimmune response leading to the development or exacerbation of psoriasis.

References: 

• Ramírez-Boscá A. Navarro-López V. Martínez-Andrés A et al. Identification of Bacterial DNA in the Peripheral Blood of Patients With Active Psoriasis. JAMA Dermatol. 2015;151 (6):670-671. do:10.1001/jamadermatol.2014.5585

• Nobbs, A. H., Lamont, R. J., & Jenkinson, H. F. (2009). Streptococcus adherence and colonization. Microbiology and molecular biology reviews: MMBR, 73(3), 407-450.https://doi.org/10.1128/MMBR.00014-09
  
  
• P. Haines Ely, Is psoriasis a bowel disease? Successful treatment with bile acids and bioflavonoids suggests it is, Clinics in Dermatology, Volume 36, Issue 3, 2018, Pages 376-389, ISSN 0738-081X, https://doi.org/10.1016/j.clindermatol.2018.03.011.

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