Leech therapy for epidermoid cysts and review of the literature

Abstract

Hirudo medicinalis sucks blood directly through the external mammalian skin. We recently observed a healthy 64-year-old Iranian man, who presented with numerous asymptomatic multilobular oval-to-round well-defined 0.5 to 1.5 cm cystic lesions with central umbilication (central black eschar) over the upper portion of his chest. We made the diagnosis of epidermoid cyst, giant comedone and leech bite on the basis of the constellation of clinical features. The patient was treated with oral ciprofloxacin at a dose of 2 g daily, and 2% topical erythromycin solution. Despite improvement, the evidence of cystic lesions persisted. There was no history of similar lesions in any other family member. There was no history of trauma. The patient was not using any topical or systemic medication. Two weeks before his visit, he had a history of leech therapy under the supervision of a general practitioner. His medical history was significant for leech therapy of the lesions, five days previously. He was followed up for another two weeks and after disappearance of the inflammation, with the patient under local anesthesia, the well-circumscribed mass was completely evacuated with a sharp curette and comedone extractor. The patient was subsequently lost to follow-up. Conclusion: Considering the efficacy of leeches, it would be favorable to breed a germ-free leech. In Iran, the use of the leeches in surgery, in recent years, has been infrequent. It appears that the positive effects of this ancient remedy may now be explained through scientific methods, promising potentially even more uses of this admirable creature in medicine.

Case Reports and Experts Opinions about Current Use of Leech Therapy in Dermatology and Cosmetology

“…The severity of infection may range from mild cellulitis, through abscess and cellulitis, to bacteremia, septic shock, and even bone necrosis [25]. An epidermal cyst may also appear at the site of leech attachment [29]. In case of an infection, it is recommended to cleanse the affected tissues and administer antibiotics.…”

What Is Need To Be Known About Medicinal Leeches And Hirudotherapy?: A Comprehensive Review

“…Psoriasis, eczematous dermatitis, chronic ulcers, epidermoid cysts, cutaneous leishmaniasis. (79,85,(147)(148)(149) Respiratory diseases To use the advantage of the mucolytic action of leech saliva for asthma, acute rhino pharyngitis, and spasmodic coryza (150).…”

Pathogenetic mechanisms of hirudotherapy and its use in otorhinolaryngology

“…Клінічними дослідженнями встановлено, що бделіни необхідні для лікування та профілактики прогресування артритів, артрозів, подагри, емфіземи легень. Вони блокують активність лейкоцитарних протеаз, які вивільняються при запальному процесі, цілющі властивості котрих ще продовжують досліджуватись [25,28,30].…”