Background: Atypical presentation of calcinosis cutis in the context of COVID-19 infection complicated by acute renal failure has not been described in literature. We report a case of severe COVID-19 infection and its associated uncommon skin manifestation. It is a rare condition and its association with different diseases has been established in the past. However, to the authors’ knowledge, calcinosis cutis has not yet been described in relation to COVID-19 infection complicated by acute renal failure. Case Presentation: Here we describe a case of a 55-year-old gentleman admitted to the intensive care unit with severe COVID-19 infection whose hospital stay was complicated by acute renal failure and development of hypocalcemia which was treated with oral and intravenous calcium. Subsequently, he developed an atypical fleshy lesion on his left ankle during his in-patient stay which was histologically proven calcinosis cutis. It was successfully treated with topical medications. Conclusion: This case highlights the importance of considering a wide differential of skin lesions including calcinosis cutis in patients who are critically unwell with COVID-19 or any other severe infections and develop isolated skin lesions in the setting of impaired renal functions and abnormal calcium phosphate metabolism with calcium administration.

Keywords: Keywords: Calcinosis cutis; severe; Covid-19; SARS-COV-2: acute renal failure