For 3 days, a 28-year-old woman with a history of polymyositis and possible dermatomyositis had fever, chills, and nonproductive cough. She complained of rash, joint pain, and progressive immobility because of severe muscle weakness. For the past 6 years, she had been taking pred-nisone (60 mg/d), hydroxychloro-quine (200 mg bid), and tramadol (100 mg q6h prn for pain).The patient's vital signs were normal. She had a moon fades, and crackles were heard bilaterally in the lower lung fields. She had diffuse violaceous, desquamative plaques (A) in the antecubital fossae and on the posterior aspect of the knees and thighs (B). There was no evidence of Gottron papules.Other than an aspartate amino-transferase level of 82 U/L, results of a chemistry panel were normal.
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机译：一名28岁的女性，患有多发性肌炎和可能的皮肌炎，有3天发烧，发冷和无生产性咳嗽，持续3天。她抱怨由于严重的肌肉无力而出现皮疹，关节痛和进行性不动。在过去的6年中，她一直服用泼尼松（60毫克/天），羟氯喹（200毫克每日两次）和曲马多（100毫克每6小时疼痛一次），患者的生命体征正常。她的月亮变淡了，在下肺部两侧听到了heard啪声。她在肘前窝以及膝盖和大腿后侧（B）处散布着紫色，脱落性斑块（A）。没有Gottron丘疹的迹象。除了天冬氨酸转氨酶水平为82 U / L外，化学检查结果正常。
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