THERAPEUTIC POTENTIAL OF HIRUDOTHERAPY (IRSAL-I- ALAQ) IN THE MANAGEMENT OF PLAQUE PSORIASIS: A CASE STUDY

Psoriasis is a widely prevalent, chronic, inflammatory, disfiguring, and autoimmune skin disorder marked by intermittent exacerbations and global distribution. The prevalence is highest among Europeans and lowest among East Asians. In classical Unani literature, various terminologies are used to describe psoriasis and its manifestations, including Qoob-i-Mutaqashshira, Taqashshur al-Jild, Talaq, and Qashaf al-Jild. As per Unani understanding, the condition is believed to stem from an imbalance in bodily humorsprimarily an abnormal state of Khilt-e-Sauda (black bile) or Safra Ghair Tabai (Abnormal Yellow Bile), involving qualitative and quantitative disturbances that contribute to the disease pathology.This case study focuses on a 35-year-old female patient diagnosed with Plaque Psoriasis, confirmed through detailed history-taking, physical examination, and clinical presentation. She underwent weekly sessions of leech therapy (Irsal-i-Alaq) for eight consecutive weeks. In each session, a total of six leeches were applied three on each leg, including two leeches at the adjacent to the affected knee site and one at the foot on the same leg. The procedure was repeated after a gap of seven days for a total of eight sittings, and the patient was subsequently followed up for next two months. Therapeutic response was quantified using the site-specific Psoriasis Area and Severity Index (PASI), which showed a significant reduction from a baseline score of 22.8 to 1.1 at the end of treatment, indicating approximately 95% clinical improvement. Notably, there was complete resolution of pruritus and scaling, with marked reduction in erythema and induration. These results suggest that hirudotherapy is a safe, well-tolerated, and efficacious Unani intervention for the management of psoriasis.