Patient presents with a constellation of signs and symptoms suggestive of systemic lupus erythematosus (SLE).  Chief complaints include persistent fatigue, arthralgia involving multiple joints, and a malar rash exacerbated by sun exposure.  Review of systems reveals constitutional symptoms such as fever, weight loss, and malaise.  The patient also reports intermittent headaches, Raynaud's phenomenon, and photosensitivity.  Physical examination confirms the presence of the characteristic butterfly rash across the bridge of the nose and cheeks.  Joint examination reveals tenderness and swelling in the wrists and small joints of the hands, consistent with non-deforming arthritis.  Cardiopulmonary examination reveals a friction rub, raising suspicion for pericarditis.  Laboratory findings demonstrate positive antinuclear antibodies (ANA), elevated anti-dsDNA antibody titers, and low complement levels (C3 and C4), supporting the diagnosis of SLE.  Differential diagnoses considered include rheumatoid arthritis, Sjogren's syndrome, and mixed connective tissue disease.  Based on the patient's clinical presentation, laboratory results, and fulfillment of the American College of Rheumatology (ACR) classification criteria for SLE, a diagnosis of systemic lupus erythematosus is made.  The patient is counseled on the chronic nature of the disease, its potential systemic manifestations, and the importance of ongoing monitoring.  Initial treatment plan includes hydroxychloroquine for disease control, nonsteroidal anti-inflammatory drugs (NSAIDs) for arthralgia and inflammation management, and sun protection measures to minimize photosensitivity reactions.  Referral to a rheumatologist is made for ongoing specialist care and further evaluation of potential organ involvement, including renal and neurological assessments.  Patient education materials on lupus management, medication side effects, and lifestyle modifications are provided.  Follow-up appointment is scheduled to monitor disease activity, assess treatment response, and address any emergent symptoms.  ICD-10 code M32.9, Systemic lupus erythematosus, unspecified, is assigned.