Post-kala-azar dermal leishmaniasis (PKDL) is a rare clinical variant of cutaneous leishmaniasis. It is very common in the Indian subcontinent and less frequent in East Africa, but exceptional in the American and European continents. We have observed a case of PKDL in a renal transplant recipient. No systemic symptoms were present. The patient was treated with liposomal amphotericin B. We emphasize the unusual aspects of this case: the appearance of PKDL in Europe, its relationship with immunosuppression, the severe mucosal involvement and the excellent response to liposomal amphotericin B, a newly described treatment for the disease.