Nokea
A 44-year-old female presents with weakness. Her weakness becomes apparent when she picks up her youngest daughter, or when placing her nonperishable foods in the top shelf of her kitchen. She also reports difficulty when getting up from a chair. These symptoms began a few months ago, and have since worsened. On physical exam, there is an erythematous eruption on her eyelids, and erythematous papules on the dorsal aspect of her hands. Neurological examination is significant for symmetric muscle weakness of her shoulders and hips. Which of the following is most likely the diagnosis?
Correct Answer: C
Rationale: The patient's presentation of proximal muscle weakness, along with the characteristic skin findings (heliotrope rash on the eyelids and Gottron's papules on the hands), is classic for dermatomyositis. This is an inflammatory myopathy associated with autoimmune processes and often involves both muscle and skin. Glucocorticoid-induced myopathy and myasthenia gravis do not present with skin changes, while polymyositis and systemic lupus erythematosus do not typically cause the specific skin lesions seen in this patient.