A 32-year-old woman comes to the
physician because of a difficulty swallowing and shortness of breath on
exertion. She says that these symptoms started about 6 months ago and have been
getting progressively worse. Physical examination shows symmetric skin thickening
of the proximal and distal extremities, face, and trunk. Bilateral basilar rales
are heard on auscultation. Laboratory studies show antitopoisomerase I
antibodies. Which of the following is the most likely diagnosis?
A. Dermatomyositis
B. Polymyositis
C. Scleroderma
D. Sjogren syndrome
E. Systemic lupus erythematosus
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