26th February 2025

A 19-year-old female is referred to rheumatology clinic with joint pains.

A 19-year-old female is referred to rheumatology clinic with joint pains. She has particularly noticed pain in her knees and her hands, and this is migratory in nature. She has also been increasingly fatigued recently and has intermittently felt feverish. She has also noticed a rash across her face and photosensitive rashes to her chest and forearms. 

On examination, you notice a rash across the cheeks and the bridge of the nose, sparing the nasolabial folds. She also has an erythematous maculopapular rash affecting sun-exposed sites, particularly chest and forearms. There is no obvious synovitis on examination. 

Blood tests reveal the following:

What is the most likely diagnosis?

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