A patient is admitted with a purple rash on her eyelids and a slightly red rash on her face and neck. The patient tells the nurse that her muscles "hurt" and she fatigues easily. Which of the following do these findings suggest to the nurse?
1. Dermatomyositis
2. Inclusion body myositis
3. Polymyositis
4. Mitochondrial myopathy
Dermatomyositis
Rationale: Dermatomyositis is an autoimmune disease that affects the small blood vessels and capillaries in muscles. A bluish-purple rash on the eyelids with redness of the face, chest, and neck are commonly seen. Muscle weakness and fatigue is a gradual process that develops over several months. Inclusion body myositis occurs primarily in men over age 50 and is characterized by asymmetrical muscle weakness. Individuals diagnosed with polymyositis may also have a rash but the primary symptom is weakness in the upper and lower extremities. Symptoms of mitochondrial myopathy include muscle weakness, exercise intolerance, hearing loss, loss of balance and coordination, and seizures.
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