<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 52-year-old woman comes to the physician because of vaginal itchiness and urinary frequency for the past 1 year. She stopped having vaginal intercourse with her husband because it became painful and occasionally resulted in vaginal spotting. Her last menstrual cycle was 14 months ago. She has vitiligo. Her only medication is a topical tacrolimus ointment. Her temperature is 37.1C 98.8F, pulse is 85min, and blood pressure is 13582 mm Hg. Examination shows multiple white maculae on her forearms, abdomen, and feet. Pelvic examination shows scarce pubic hair, vulvar pallor, and narrowing of the vaginal introitus. Which of the following most likely contributes to this patients current symptoms?? A: Thinning of the mucosa, B: Inflammation of the vestibular glands, C: Decrease of pH, D: Dysplasia of the epithelium, E: Sclerosis of the dermis,  <response>: This is a patient with symptoms of vaginal itchiness, urinary frequency, painful intercourse, and vaginal spotting that started 1 year ago. She is postmenopausal based on her last menstrual cycle being 14 months ago. She has vitiligo which is an autoimmune condition. On exam she has vulvar pallor and vaginal narrowing. The key finding is the vaginal narrowing which indicates vaginal atrophy due to low estrogen levels after menopause. This leads to thinning and inflammation of the vaginal mucosa which can cause the symptoms she is experiencing.Choices A and B directly describe the thinning and inflammation of the vaginal mucosa which is the most likely cause of her symptoms. Choice C is incorrect because pH changes are not a primary cause. Choice D is incorrect because dysplasia refers to precancerous changes in the epithelium which is not described. Choice E refers to changes in the dermis which is deeper and not directly related to her symptoms.A: Thinning of the mucosa 