A 51-Year-Old Woman with Multiple Dermatological Symptoms and Muscle Weakness

The patient is a 51-year-old woman who presented to urgent care complaining of a rash, pruritus, myalgias, and muscle weakness. The rash was an erythematous blanching patch spread across her chest in a V shape. She had also noticed that her fingernail folds were red and swollen.

The patient can’t recall when she first noticed her symptoms, but reports that they’ve started affected her everyday life (such as having difficulty rising from a chair) within “the past couple of weeks”

View the image taken and consider what your diagnosis and next steps would be.