A 45-year-old practical nurse developed a chronic paronychia, not responsive to customary surgical therapy. The refractory nature of this paronychia and the development of axillary lymphadenopathy dictated the need for biopsy and culture. This procedure subsequently yielded Mycobacterium tuberculosis. Systemic antituberculous chemotherapy resulted in a prompt resolution of the indolent paronychia. This case exemplifies the need for mycobacterial, fungal, or viral studies when confronted with treating the chronic paronychia. In addition, it reemphasizes the frequency with which cutaneous tuberculosis occurs in medical personnel.