Heliotrope rash is seen in?

ANSWER: (D) Dermatomyositis REF: Harrison's 17th ed chapter 383DERMATOMYOSITISDM is a distinctive entity identified by a characteristic rash accompanying, or more often preceding, muscle weakness. The rash may consist of a blue-purple discoloration on the upper eyelids with edema (heliotrope rash) a flat red rash on the face and upper trunk, and erythema of the knuckles with a raised violaceous scaly eruption (Gottroris sign).The erythematous rash can also occur on other body surfaces, including the knees, elbowTs, malleoli, neck and anterior chest (often in a Vsign), or back and shoulders (shawl sign), and may worsen after sun exposure.In some patients the rash is pruritic, especially on the scalp, chest, and back. Dilated capillary loops at the base of the fingernails are also characteristic. The cuticles may be irregular, thickened,and distorted, and the lateral and palmar areas of the fingers may become rough and cracked, with irregular, "dirty horizontal lines, resembling mechanic's hands.