Case 349

Case 349

Medical history

50 year-old male patient, refers proximal-member weakness and skin rash on arms and proximal interphalangeal and metacarpophalangeal articulations’ extensor face (Images 1 and 2). Denies photosensitivity. Antinuclear auto-antibody (FAN) positive on homogeneous (1:160) and speckled (1:640) patterns, and creatine-phosphokinase of 1935 U/L. Lesion biopsy revealed chronic superficial inflammatory infiltrate. 

Considering the clinical data and the images, the most likely diagnosis is:

Test question

(Medical Residence 2009 – UNB) 

A 48 year-old patient referred progressive and symmetric loss of proximal muscle strength over the past six months. Refers loss of 8 kg on the last year. At examination, shows signs of arthritis on the small and big articulations, besides heliotrope and malar rash (including the nasolabial folds) and Gottron’s papules. 

From the clinical data, the most likely diagnosis for this patient is: