Amelia Barksdale (pronouns: she/her/hers) is a 30-year-old female

Amelia Barksdale (pronouns: she/her/hers) is a 30-year-old female. Last week, she had a telemedicine appointment with her primary care provider to discuss her concerns about a rash on her arms, legs, and face after sun exposure and increased fatigue. After sending Amelia for lab testing and receiving the results, the primary care provider called Amelia back to the office for an exam. Review all tabs of the electronic health record and select all the clinical manifestations that indicate that Amelia potentially has systemic lupus erythematosus (SLE) based on the information provided. Patient Identification Progress Notes Vital Signs Laboratory Results Date/TimeProvider Progress Notes11/6/XX 1145Client complains of rash on arms, legs, and face after sun exposure despite always wearing sun protection. Client states this rash has occurred multiple times over the past 6 months but is getting worse. Client also complains of extreme fatigue, also getting worse over the past 6 months. Client has no past medical history, no allergies, and does not smoke. Client AAOx4, denies nausea, vomiting, diarrhea, headache, or recent illness. Malar rash noted to nose and cheeks of face in the shape of a butterfly, also noted to arms and legs. Client states it does itch but she has been trying not to scratch it. Lungs clear to auscultation bilaterally. No evidence of enlarged lymph nodes. Cardiac auscultation demonstrates normal sinus rhythm with no rubs, murmurs, or gallops. Abdomen soft, nontender, nondistended with bowel sounds auscultated in all four quadrants. Neuromuscular system intact in all four extremities, no edema, full ROM. Client does state she has some muscle and joint pain occasionally, right now rating it a 4/10 in fingers and arms. Lab work completed this week demonstrates anemia, elevated ESR, and positive ANA test.