American Society of Hirudotherapy

Cutaneous lymphoid hyperplasia induced by Hirudo medicinalis (leeches)

Case report published in Journal of complementary & integrative medicine (2019)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical LiteratureSadati M et al. · Journal of complementary & integrative medicine, 2019

Abstract

For centuries, Hirudo medicinalis (medicinal leech) has been used as a remedy to treat many discomforts, such as muscle and joint pain. Nowadays, using leech in reconstructive surgery, microsurgery, wound and flap healing, venous insufficiency, varicosities and many other disorders has increased. In this study, we report a 45 year old female patient with six pruritic papules on her legs since10 months ago that appeared about 4 weeks after one session of leech application. Skin biopsy was performed on one of the papules, and in histopathology, superficial ulceration with a dense superficial and deep inflammatory infiltrate within the dermis composed of lymphocytes and eosinophils detected that considering history of leech application at this site, these constellation of data was compatible with the diagnosis of cutaneous lymphoid hyperplasia induced by leeches and the patient was cured by a topical steroid and cryotherapy.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article
Indexed MeSH termsAdministration, TopicalAnimalsAnti-Inflammatory AgentsFemaleHirudo medicinalisHumansLeechingMiddle AgedMometasone FuroatePseudolymphomaSkin Diseases

Summary

A 45-year-old woman developed six pruritic leg papules about four weeks after Hirudo medicinalis leech application; biopsy showed a dermal lymphocyte and eosinophil infiltrate compatible with cutaneous lymphoid hyperplasia, cured by topical steroid and cryotherapy.

Why This Matters for Hirudotherapy

This case report describes a 45-year-old female patient who developed six pruritic papules on her legs approximately four weeks after a single session of medicinal leech (Hirudo medicinalis) therapy. Histopathological examination revealed superficial ulceration with a dense dermal inflammatory infiltrate composed of lymphocytes and eosinophils, consistent with a diagnosis of cutaneous lymphoid hyperplasia induced by leech application; the lesions resolved with topical steroid and cryotherapy. For hirudotherapy practitioners, this report is relevant because it documents a rare but recognized delayed cutaneous adverse reaction to medicinal leech therapy, reinforcing the need for post-procedure monitoring and patient counseling on potential skin complications. The key limitation is that this is a single case report—it cannot establish incidence, risk factors, or definitive causality, and it does not diminish the established efficacy of leech therapy in its well-validated surgical and reconstructive applications.

Citation

Reference (Vancouver style)

Sadati MS, Rezaee M, Ghafarpur S, Aslani FS, Dastgheib L, Jahankhah R. Cutaneous lymphoid hyperplasia induced by Hirudo medicinalis (leeches). J Complement Integr Med. 2019;16(4). doi:10.1515/jcim-2016-0056. PMID: 31804958

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

Added to ASH library: March 18, 2026 · Site last updated: November 1, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.