Derm Dx: A confluent swollen itchy symmetrical rash on the cheeks and bridge of the nose

A 55-year-old woman presents with a confluent swollen itchy symmetrical rash on the cheeks and bridge of the nose, with a separate similar lesion on her chin. She has a fever and lymphadenopathy and reports fatigue and general malaise.

Pitting and ridging of the nails and telegentsia are noted on physical exam. The woman has a medical history of arthritis in ...