Limitation of Jalauka (medicinal leech) application in the prevention of recurrence of keloid

Abstract

Keloid can be defined as a benign dermal fibroproliferative disorder with no malignant potential. The keloids tend to occur following trivial physical trauma in genetically predisposed individuals. Jalauka (medicinal leech, Hirudo medicinalis) is famed to use in all skin disorders caused by vitiation of Rakta (~blood) and Pitta Dosha (a functional regulatory factor of the body). Many studies also have claimed that the saliva of medicinal leeches potentiates wound healing. It helps in healthy scar formation by inhibiting the conversion of fibrinogen to fibrin. Therefore, a hypothesis was made that medicinal leech application can be helpful in the healing of the wound without keloid formation in patients with keloid formation tendencies. In the present study, case of a 38-year-old male patient infected sebaceous cyst at the right upper back (scapular region) with a previous history of keloid formation after surgical scar was treated by weekly medicinal leech application five times after excision of the cyst under local anesthesia. Initiation wound healing was normal in the studied case until complete epithelization. After 2 months of complete healing, gradual hardening and shiny appearance with irregular margin became very prominent and seemed to convert in keloid, although other associated symptoms were absent. The findings of this case report indicate the limited effect of the medicinal leech application and the requirement of a multimodel therapeutic approach for healthy wound healing in keloid tendency patients.