A 48-year-old previously healthy woman visits the office because she has been experiencing progressively worsening muscle weakness for the past two months. Climbing stairs, getting up from chairs, and putting dishes in overhead cabinets are all difficult for the patient. She also reports an unintentional weight loss of 4.5 kg (10 lb) and occasional abdominal discomfort during the same time period. Physical examination reveals shoulder and hip girdle muscle weakness. The image below depicts additional examination findings. Further evaluation of this patient is most likely to reveal which of the following associated conditions?

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Eductional Objective: Dermatomyositis is distinguished by proximal muscle weakness similar to polymyositis, as well as additional inflammatory features involving the skin (heliotrope rash, Gottron papules). Dermatomyositis and polymyositis can occur on their own or as a paraneoplastic syndrome in conjunction with an underlying adenocarcinoma (eg, ovary, lung, pancreas).

A 48-Year-Old Previously Healthy Woman Visits the Office Because She