A 45-year-old man presents to the office with weakness and the lesions on his hand pictured. His symptoms have been progressively worsening over the last 5 months. He works as a nurse and has had difficulty walking up the stairs and lifting patients. He has a history of frontal migraines for which he occasionally takes ibuprofen. He takes a cholesterol lowering medication and is otherwise healthy. Physical exam yields proximal muscle weakness in the upper and lower extremities. A picture of the skin findings is found here. This patient is at increased risk of which of the following?

A. Hypothyroidism

B. Malignancy

C. Visual loss

D. Acute renal failure

E. Rhabdomyolysis

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