30-year-old Primigravid in Medicine / Internal Medicine — Case | Rheumatology | SMLE Q#8971

SMLE Question #8971

Medicine / Internal Medicine Rheumatology

Objective: OBJ-383

Last updated: February 2026
A 30-year-old primigravid woman at 24 weeks’ gestation reports 2 months of progressive fatigue, photosensitivity, painful oral ulcers, and joint pain. Examination shows swelling and tenderness of the metacarpophalangeal and metatarsophalangeal joints and an erythematous rash over both cheeks that spares the nasolabial folds. What is the most likely diagnosis?

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