Therapeutic Effectiveness of Siddha Leech Therapy(Attai Vedal) in Managing Chronic Urticaria: A Clinical Case Report

Chronic urticaria, known as Kaanakadi in Siddha medicine, is a persistent condition characterised by pruritic wheals, angioedema, or both lasting for more than one month. This case report presents a 37-year-old male with a 4-year history of recurrent cutaneous allergic reactions, manifesting as widespread urticarial wheals, mild angioedema, and rhinitis. The patient's symptoms were refractory to conventional treatments, including antihistamines and corticosteroids. Siddha medicine attributes the pathophysiology of chronic urticaria to gastrointestinal imbalance and psychological factors. The patient underwent Siddha management to alleviate symptoms associated with Pitham and Kabham. Siddha leech therapy is considered a promising treatment for dermatological conditions. Along with oral medication and three sessions of Siddha leech therapy with a gap of 6 days between sessions over 24 days, the patient experienced significant alleviation of pruritus, rash formation, and irritability. No adverse reactions were observed at the site of the leech therapy. Recent studies have demonstrated that leech saliva contains bioactive peptides and proteins with antithrombotic, antiplatelet, and antimicrobial properties. A systematic review indicated that bloodletting was more efficacious than pharmaceutical interventions in managing chronic urticaria, with comparable response rates and no significant adverse events. This case highlights the potential of Siddha leech therapy as an adjunctive treatment for chronic urticaria refractory to conventional management.