26th May 2025

A 42-year-old lady presents with a 6-month history of general malaise and lethargy.

A 42-year-old lady presents with a 6-month history of general malaise and lethargy. She also complains of joint pain and swelling of the small joints of her hands and ankles. On direct questioning, she admits to increased hair loss and a photosensitive rash across her face- this rash spares the nasolabial folds. Which of the following examination findings is most likely to support the underlying diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.