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In this study, two experiments were made to investigate the immunological pathogenesis of PPP, a skin disease of so-called focal infections. One was the immunohistological study on tonsils with PPP and recurrent tonsillitis. In the investigation, monoclonal antibodies against T lymphocytes and anti-immunoglobulin antibodies were used to reveal the distribution of T and B cell subsets on frozen sections of tonsils. But no difference between tonsils with focal infection and recurrent tonsillitis was observed in the distribution of T and B cell subsets. The other was the identification of a common antigen between tonsillar epithelium of PPP and hand-sole skin by use of one monoclonal antibody against PPP-tonsillar epithelium, which was made in our laboratory. Monoclonal antibody ATE-3 was in IgM, and recognized about 35 kilo dalton molecular weight protein of a tonsillar epithelium of PPP. This antibody reacted with the basal layer cells of the tonsillar epithelium and the suprabasilar cells of plantar skins of PPP. But ATE-3 did not react with normal tonsillar epithelium and normal plantar skin.
In connection with the cases of a group of patients hospitalised in Departments of Infectious Pathology, the authors consider the various general and visceral symptoms caused by the focal infection. In these statistics, fever occupies the first place and in its isolated form poses difficult diagnostic problems which can only be solved by a process of elimination. Repeated biological tests and careful attention to the clinical symptoms are necessary to link what has been observed to an infection which, it should be stressed, is descrete. Articular lesion, very different from acute articular rheumatism, cutaneous, ocular and renal symptoms are each in turn discussed and analyzed. From their personal observations, the authors recall the possibility of serous lesions and, in particular, of recurrent pericarditis. A summing-up of the theories concerning prescription completes this clinical survey which ends by recalling the function of the oto-rhino-laryngologist in the search for the causal infection and the difficulties involved in ascribing responsibility to an almost invariably latent focal infection.