39 years old female from Tokha initially presented with 5 months history of shortness of breath progressive in nature along with non productive cough with pleuritic chest pain and also had episodes of fever and was treated in outside centre as post COVID fibrosis with no response. That time her rash in palmar surface of fingers and ulcer in same area was missed. She was later evaluated for the same and CECT chest showed fibrotic NSIP type of interstitial lung disease and her myositis panel showed MDA-5+++ & Ro-52 + and was finally diagnosed as MDA-5 positive dermatomyositis with rapidly progressive interstitial lung disease and treated with rituximab induction & later maintainance dose and she is doing well. So MDA-5 dermatomyositis can be missed in busy clinical settings so this has to be considered if typical skin rash with ulcers are present.

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