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A 52-year-old woman presents with a facial rash (see photo) that first appeared 2 months ago. She also reports an itchy rash on her scalp, chest, and upper back. She is an archaeologist and notes that the rash worsened after she led an excavation during the summer.

More recently, she noticed scaly red bumps on the back of her hands, particularly on the skin over the joints of her fingers, and a reddish-purple rash on her elbows. She does not report any weakness but has felt fatigued and unintentionally lost 15 pounds. She currently does not have any other medical issues and takes no medications.

The image and case history are most suggestive of:

A) Systemic lupus erythematosus
B) Polymorphous light eruption
C) Dermatomyositis
D) Sweet syndrome
E) Allergic contact dermatitis

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