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A 24-year-old woman undergoes medical evaluation for kidney failure and epilepsylike convulsions that fail to respond to antiepileptic drugs. Her most visible sign of illness, though, is a red rash extending over the bridge of her nose and onto her cheeks, in a shape resembling a butterfly.
A 63-year-old woman insists on hospitalization to determine why she is fatigued, her joints hurt, and breathing sometimes causes sharp pain. Ever since her teen years she has avoided the sun, which raises painful blistering rashes wherever her skin is unprotected.