Clinical Efficacy of Leech Therapy (Ta'līq al-'Alaq) in Eczema (Nār Fārsī): An Open-Label Single-Arm Clinical Study.

Eczema, known as Nār Fārsī in Unani medicine, is a chronic skin disorder characterized by intense pruritus, dryness, and scaling of skin, along with periodic flares and remissions. Unani literature recognizes it as a disorder caused by safrāwī (bilious) humor. Conventional treatment relies on emollients, humectants, and anti-inflammatory drugs. Unani medicine recommends the expulsion of morbid matter by local blood-letting or oral therapies. Leech therapy, used in many traditional medicine systems for centuries, is a method of expulsion of morbid humors from a disease site. It is prescribed for diseases of joints, skin, the nervous system, etc. Contemporary research has identified many bioactive enzymes and proteins in leech saliva that have anti-inflammatory, analgesic, vasodilatory, antimicrobial, and many other effects. This study aimed to assess the efficacy and safety of leech therapy in eczema patients based on standard parameters. An open-label, single-arm clinical study was conducted on 20 patients diagnosed with eczema. Four sessions of leech therapy were carried out with a one-week gap in between. The effectiveness of leech therapy was assessed using the Eczema Area and Severity Index (EASI) Score. Statistically significant improvement was observed in the severity of eczema, as reflected in the EASI Score parameters, i.e., redness (P = .0001), edema (P = .0001), excoriation (P = .0022), and lichenification (P = .0001). However, the decrease in total area involved was not statistically significant (P = .24). Leech therapy was found to be safe and effective in relieving the severity of eczema. All patients expressed satisfaction with the treatment, without any drop-outs, indicating excellent adherence to the therapy. With further research, leech therapy may provide positive outcomes in eczema in clinical settings, providing relief to the suffering patients.