Dermatomyositis is clinically similar to polymyositis, but also involves _______________________, photodistributed facial erythema, "shawl and face" rash, darkening and thickening of the fingertips, and is characterized by perimysial inflammation and atrophy with CD4+ T cells.
a. joint pain
b. skin changes
c. respiratory distress
d. gastrointestinal symptoms