Q. 30 year-old patient presents with a rash across the bridge of the nose and cheeks and reports that ever since she started on a thiazide diuretic she gets sunlight triggered rashes. She has also experienced nodular lumps deep under the skin, oral and nasal ulcers, vasospasm in the hands, recent chest pains, and she is worried about excessive urination that is foamy and blood-tinged. Which of the following is MOST convincing for your suspected diagnosis?