American Society of Hirudotherapy

Cutaneous pseudolymphoma after hirudotherapy : Case report and review

Case report and review published in Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete (2022)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical LiteratureGenomics & ProteomicsHanner S et al. · Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 2022

Abstract

The term cutaneous pseudolymphoma (C-PSL) is defined in the literature as a benign, reactive lymphoproliferation that clinically and/or histopathologically imitates cutaneous lymphoma. The exact etiopathogenesis has not been fully elucidated to date. A distinction is made between primary, idiopathic PSL without an identifiable cause and secondary PSL with a known stimulus. We report the occurrence of pseudolymphoma after treatment with medicinal leeches (hirudotherapy). To the best of our knowledge, a total of only nine cases of cutaneous PSL after hirudotherapy have been reported in the literature to date. Unter dem Begriff Pseudolymphom (PSL) versteht man eine benigne, reaktive Lymphoproliferation der Haut, die klinisch und/oder histologisch ein malignes Lymphom simulieren kann. Die genaue Ätiopathogenese ist bis heute nicht gänzlich geklärt. Man unterscheidet die primären, idiopathischen PSL ohne erkennbare Ursache von den sekundären PSL mit bekanntem Stimulus. Wir berichten über das Auftreten von Pseudolymphomen nach einer Behandlung mit medizinischen Blutegeln (Hirudotherapie). Bisher wurden nach bestem Wissen und Gewissen insgesamt nur 9 Fälle von kutanen PSL nach Hirudotherapie in der Literatur beschrieben.

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

Publication typeCase ReportsJournal Article
Indexed MeSH termsHumansLymphoma, Non-HodgkinPseudolymphomaSkin Neoplasms

Summary

This case report and literature review describe cutaneous pseudolymphoma, a benign reactive lymphoproliferation mimicking lymphoma, occurring after hirudotherapy, and note that only nine such cases have been reported to date.

Why This Matters for Hirudotherapy

This case report describes the development of cutaneous pseudolymphoma—a benign reactive lymphoproliferation that can clinically and histologically mimic cutaneous lymphoma—following hirudotherapy with medicinal leeches, and notes that only nine such cases have been reported in the literature to date. It documents a rare but recognized adverse cutaneous reaction to leech therapy, reinforcing the need for practitioners to be aware of uncommon inflammatory or immune-mediated responses to leech salivary constituents and to consider pseudolymphoma in the differential diagnosis of post-treatment skin lesions. As a single case report with narrative review, it cannot establish incidence, causation, or risk factors for pseudolymphoma after hirudotherapy, and its primary value is as a safety signal rather than evidence of frequency or mechanism.

Citation

Reference (Vancouver style)

Hanner S, Stroh H, Enk A, Hoffmann J. [Cutaneous pseudolymphoma after hirudotherapy : Case report and review]. Hautarzt. 2022;73(2):152-155. doi:10.1007/s00105-021-04812-6. PMID: 33884433

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.