<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 42-year-old man presents to clinic complaining of increasing difficulty climbing stairs and standing up from sitting in his chair. On exam you perceive that his strength to be 55 distally, but only 35 in proximal muscle groups bilaterally. There is a distinctive rash on his upper eyelids and around his eyes. Examination of the fingers is most likely to reveal which of the following?? A: Dactylitis, B: Enlargement of the PIP, C: Ulnar deviation of the fingers, D: Nail pitting with oil spots, E: Violaceous papules over the MCP, PIP, and DIP,  <response>: This is a clinical vignette describing a patient with proximal muscle weakness and a distinctive rash around the eyes. The history and physical exam findings are classic for dermatomyositis, an autoimmune inflammatory myopathy. Dermatomyositis classically causes proximal muscle weakness and a characteristic heliotrope rash on the eyelids along with Gottrons papules over the knuckles. Therefore, the correct answer is likely to describe the skin findings of Gottrons papules.E: Violaceous papules over the MCP, PIP, and DIP 