A 63-year-old woman develops skin lesions, and difficulty getting out of a chair. A clinical diagnosis of dermatomyositis is made. What might the findings include?For the above patient, select the associated skin and clinical findings.

In dermatomyositis, the dermatitis may be the most striking feature of the illness or so minor as to be easily overlooked. The classic manifestation is a purplish-red heliotrope erythema of the eyelids, upper cheeks, forehead, and temples, often with edema of the eyelids and of the periorbital tissue. Telangiectasia and skin atrophy can also occur. The typical hand changes involve scaly, bluish-red plaques around the base of the nails and backs of the joints of the fingers. These are most frequently found in elderly patients and are called Gottron papules. There is an association with malignancy in those over 55 years of age.