Localized Cutaneous Hypersensitivity FollowingJalaukavacharana in a Patient with AutoimmuneThyroiditis: A Case Report

Background: Jalaukavacharana (leech therapy) is an Ayurvedic para-surgical proceduregenerally used in the management of inflammatory and vascular conditions of the skin andunderlying soft tissues. Adverse cutaneous reactions following leech application, althoughinfrequently reported in the literature, represent an important clinical consideration. Wereport the case of a 34-year-old female with autoimmune thyroiditis, who developed alocalized cutaneous hypersensitivity reaction manifesting as pruritus, erythema, and raisedpurpuric papules at the leech bite sites following leech therapy over the anterior neck regionfor thyroid swelling. The reaction was classified as savisha jalauka damsa per Sushruta. Thecondition was relieved by topical application of Vilwadi Gulika, as mentioned by Vagbhata inVisha Chikitsa, within five days, without systemic complications. This case provides valuableinsight into dermatological complications of leech therapy and underscores the potential ofVisha Chikitsa in its management.