Dermatology Question 26

A 52-year-old woman is evaluated for a 1-month history of a spreading rash on her back, chest, and arms. She has been using over-the-counter topical glucocorticoids without relief. She does not have any other associated symptoms and otherwise feels well. Medical history is significant for hypertension. Medications are hydrochlorothiazide and metoprolol.

On physical examination, temperature is 37.1 °C (98.7 °F), blood pressure is 141/83 mm Hg, pulse rate is 72/min, and respiration rate is 18/min. Skin findings are shown.

There are no lesions in the scalp or ears, no finger or nail changes, no joint inflammation, and no oral ulcers. The remainder of the physical examination is unremarkable.

Laboratory studies:

Antinuclear antibodies

Positive (titer of 1:320)

Anti-Ro/SSA antibodies

Positive

Anti-La/SSB antibodies

Negative

Antihistone antibodies

Negative

Creatine kinase

Normal

Which of the following is the most likely diagnosis?

A Dermatomyositis

B Pemphigus foliaceus

C Psoriasis

D Subacute cutaneous lupus erythematosus

Choose an Answer Above

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