No distress is observed when examining the patient.

• T: 37.2°Cs
  
• BP: 110/70 mmHg
  
• HR: 78
  

Other findings:

• Maculopapular rash on her upper arms, shoulders, extensor forearms and dorsal hands
• Slightly raised rash over the bridge of her nose and on her cheeks and chin
• Several small ulcers seen in her mouth and nasal septum
• Ulcers are <0.5cm, shallow, painless erosions
• Periungual erythema noted
• A few areas of patchy alopecia on the scalp
• Three bruises noted over 4 cm in diameter each on her thighs and lower legs (attributed to volleyball)
• No sclerodactyly
• Chest, cardiovascular abdominal exams normal
• Thyroid normal
• Breast and pelvic examinations normal
• The metacarpophalangeal joint (MCP) and proximal interphalangeal (PIP) joints in the hands tender but not obviously swollen
• Muscle strength normal
• Reflexes normal
• Fibromyalgia tender points negative.