Answer 1 Dermatomyositis. This patient likely has dermatomyositis with the characteristic proximal muscle weakness and heliotrope rash. Polymyositis would be a consideration if the characteristic rash (ie, heliotrope eyes) was not present. The presence of characteristic skin rashes differentiates dermatomyositis from polymyositis. Muscular dystrophy is unlikely because it is an inherited disorder with lifelong weakness and distal muscle hypertrophy. Myasthenia gravis generally presents with diplopia and muscle weakness that worsens with activity. Click here to return to the questions

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