Worse with sun exposure. History of rheumatoid arthritis. Lo | Figure 1

Worse with sun exposure. History of rheumatoid arthritis. Located on face and upper extremities.

Case Details

This case is a 45 yo white female with 1 child.
HPI: presents with multiple rashes on her arms and legs after periods of being in the sun. she also has several places of hair loss which she states is from stress. She also c/o a lack of energy and always needs to take naps.
PMH: arthritis in hands and elbows, heartburn.
PSH: none.
FH: sister with rheumatoid arthritis, aunt with pernicious anemia, mother died of graves disease.
SH: married with 1 child, nonsmoker, no etoh use, or drug use.
NKDA
Medications: naproxen, tums.
ROS: as above, otherwise WNL.
VS: 109/71, HR 72, RR 15, temp 99.8 oral.
Labs:

Name your diagnosis!

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