Leishmaniasis is a broad spectrum of diseases that affect humans, and can manifest in various clinical forms. The WHO considers leishmaniasis as one of the six most important infectious diseases, not only because of the high incidence and wide geographical distribution of the disease, but also because it can take forms that determine destructive, disfiguring and even incapacitating lesions. great impact on the individual's quality of life. American tegumentary leishmaniasisis (ATL) affect the skin (cutaneous leishmaniasis) and mucosa (mucosal leishmaniasis).Approximately 3 to 5% of cutaneous leishmaniasis are estimated to develop mucosal lesions. In almost 90% of the cases, ML affects the nasal mucosa. Features five stages of the disease. Stage I being characterized by nodulation in the nasal septum mucosa, Stage II a fine-grained superficial ulceration, Stage III a deep-grained ulceration, Stage IV nasal septum perforation, and Stage V destruction of the nasal pyramid. It is known that antimony therapy is not the best drug for ATL, but due to the high cost of liposomal amphotericin B, antimony continues to be the first choice drug for treatment of ML . The standard treatment for the most cases of ML is pentavalet antomony. However, this drug has several adverse effects and some contraindications. Of note, there has been greater use of newer and more efficacious therapies for cutaneous and ML over the past 20 years, including amphothericin B, pantamidine, miltefosine, combination of antimony and pentoxifylline and antimony with granulocyte/macrophage colony stimulating factor. The association of pentoxifylline, an inhibitor of TNF, plus antimony is more effective than antimony alone, and cure ML patients refractory to antimony. ML is associated with an exaggerated inflammatory response and TNF plays a key role in the pathology associated with these disease. Antimony therapy associated with pentoxifylline, a TNF inhibitor, has been shown to decrease the healing time in CL and ML patients, and cure patients refractory to antimony therapy. The treatment of ML is still a challenge.