Which symptom is NOT associated with dermatomyositis?

Dermatomyositis is an inflammatory myopathy characterized by muscle weakness and distinctive skin rashes. One of the hallmark symptoms of dermatomyositis is proximal muscle weakness, which significantly affects the muscles closest to the trunk, making activities like lifting objects or climbing stairs difficult.

The rashes associated with dermatomyositis include heliotrope rash (purple rash on the eyelids) and Gottron's papules (red patches over the knuckles), as well as possible involvement of the chest area with a "shawl" rash that can mimic sunburn. Therefore, rashes on the chest and red patches on the knuckles are classic findings in dermatomyositis.

Severe joint pain, while it may occur in some patients with autoimmune conditions, is not a typical or defining feature of dermatomyositis. Joint symptoms can arise, but the condition primarily centers around muscle and skin manifestations, not arthralgia. Therefore, severe joint pain is not associated with dermatomyositis, making it the correct choice. Understanding the main features of dermatomyositis helps to identify what symptoms are characteristic of this condition versus other rheumatologic disorders.