A 35-year-old female presents with progressive proximal muscle weakness, difficulty climbing stairs, and a heliotrope rash on the upper eyelids. Serum creatine kinase is 4,500 U/L. What is the diagnosis?
Answer and explanation
Correct answer: B. Dermatomyositis
- Step 1: Symmetrical proximal skeletal muscle weakness combined with elevated muscle enzymes (CK) and pathognomonic cutaneous findings (heliotrope violaceous periorbital rash and Gottron papules) defines dermatomyositis.
- Step 2: Myasthenia gravis causes fluctuating ocular and bulbar weakness without elevated muscle enzymes.
- Step 3: Polymyalgia rheumatica causes stiffness in pelvic and shoulder girdles with normal muscle enzymes.
Answer
Dermatomyositis.
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