We report a case of an immunocompetent man with a 4-year history of persistent pruritic lesions along the long axis of his forearm. The symptoms began 3 years after the patient immigrated to New York from Mexico. A histopathologic evaluation demonstrated primary cutaneous nocardiosis. This rare case of Nocardia brasiliensis infection in a nontropical area raises the possibility that the incubation period for Nocardia may be longer than previously believed. Alternatively, cutaneous nocardiosis may occur in a wider geographic area than previously recognized.