Any thoughts on this case?

30 yo f with presents with 1 mo hx of the rash shown below which is also present on ears and breast with swelling and crusting in those areas. Also c/o fatigue, sore throat, cp, and constipation. Denies smoking, EtOH and drugs. Takes B12 and recently completed a 3 day course of steroids. Denies smoking, EtOH, or drugs. Labs: BMP wnl, CBC shows Hgb 9.6 (normocytic), plts 92K, wbc 2.6., AST 105, ALT 45, GGT 115, nml ALP, nml bili. nml Cr. A1c nml. nml CRP. ESR 58. TSH 15, nml T4, TPO 44 PS... Any thoughts on this case?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Internal Medicine and IM Subspecialties Source Type: forums