Abstract
Background: Psoriasis is a disorder of skin which affects nearly 1-2% of people worldwide and approximately about 1% in India. The exact cause of the disease is still unclear however strong genetic predisposition of the disease is seen. Leech Therapy (Irsal-e-Alaq) has been fruitfully practiced by Greco-Arab physicians in management of Psoriasis since centuries.
Aim: To evaluate the efficacy of alternative non pharmacological treatment (Leech therapy) in psoriasis patients.
Materials & Methods: The present study was single group open clinical study. 40 patients were selected from the general OPD of research centre and screened before undergoing the scientific study. Leech therapy was administered once in a week with 10 leeches on the affected part. After the gap of seven days the procedure was repeated for total five sittings and was the patients were followed up for a period of one year to watch for any recurrence or relapse of the disease or related symptoms.
Results: Hirudotherapy showed excellent results in symptomatic relief in 31 % of patients and complete cure in 9% without recurrence of the disease. 60% of the patients shows mixed response of transient relief in symptoms. There was relapse of the condition due to environmental changes and different food related habits. There was marked influence of different humours predominance in acute exacerbation in Damavi (Sanguine temperament) cases. The increased exacerbations were respectively more in Damavi, Safravi (Bilious temperament), Balghami (Phelgmatic temperament).
Conclusion: The severity of psoriasis and efficacy of the leeching therapy was assessed by the Psoriasis Area and Severity Index (PASI) Scale. The study showed significant reduction in the PASI score (P < 0.01). No obnoxious side effects were observed. It was therefore concluded that Leech therapy was safe and effective in the management of psoriasis.

Key words: Hirudotherapy, Irsal-e-Alaq, Psoriasis, Unani System of Medicine