Allopurinol in the treatment of zoonotic cutaneous leishmaniasis

Twenty male patients with zoonotic cutaneous leishmaniasis were included in this study. Each patient received 1200 mg of allopurinol/day in divided doses for a duration of one month. 80% of patients had an excellent response (cure), however, sometimes leaving mild pigmented or faintly coloured skin i.e. a more or less acceptable scar, but with no recurrence for one year follow-up. The drug was well tolerated. However, it showed headache in 20%, myalgia in 10% and transient increase of liver enzymes in 20%. All these side effects disappeared at the end of treatment. The parasites have particular enzymatic reactions that have relevance for chemotherapy. Certain purine analogous are metabolised by the parasites to nucleotides and aminated to the analogous of adinine nucleotides. These halt protein synthesis and cause break down of RNA. Allopurinol is recommended in treatment of cutaneous leishmaniasis, as it is effective, cheap, orally administered, available and with less side effects.