the vast majority of cases of cutaneous leishmaniasis are represented by limb injuries. a female patient, white, presented an ulcer with infiltrated borders located on the fourth finger of the left hand following occupational exposure in an area of native forest. diagnosis of cutaneous leishmaniasis caused by leishmania of the subgenus viannia was confirmed. the patient failed to respond to treatment with antimony, but achieved clinical cure after this was associated with pentoxifylline. the case highlights the rarity of the periungual location of the leishmanial lesion and the difficulties encountered in therapy.