<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 40-year-old woman comes to the physician because of a 6-day history of painless blisters on her hands, forearms, and face. Some of the blisters have popped and released a clear fluid. She is otherwise healthy. She had been working the night shift as a security guard for the past few years and switched to the day shift 2 weeks ago. She started wearing a new metal wristwatch last week. Her mother had a similar rash in the past. Her only medication is an estrogen-based oral contraceptive. She drinks 2 beers every night and occasionally more on the weekends. She used intravenous heroin in the past but stopped 20 years ago. Vital signs are within normal limits. Examination shows bullae and oozing erosions in different stages of healing on her arms, dorsal hands, ears, and face. Oral examination shows no abnormalities. There are some atrophic white scars and patches of hyperpigmented skin on the arms and face. Further evaluation of this patient is most likely to show which of the following findings?? A: Elevated anti-Smith antibodies, B: Elevated anti-varicella zoster virus antibodies, C: Elevated anti-transglutaminase antibodies, D: Positive skin patch test, E: Increased urinary uroporphyrin,  <response>: This is a clinical vignette describing a 40-year-old woman with a 6-day history of blisters on her hands, forearms and face. The blisters are painless and some have ruptured, releasing clear fluid. She recently switched from night shift to day shift work and started wearing a new metal wristwatch. Her mother had a similar rash in the past. She takes oral contraceptives and drinks alcohol. She has a remote history of IV heroin use. On exam she has bullae and erosions in different stages of healing. The key findings are painless blisters in sun-exposed areas, temporal association with change in work schedule and new wristwatch, family history of similar rash, and presence of scars and skin hyperpigmentation. This clinical presentation is most consistent with porphyria cutanea tarda PCT, a disorder of heme biosynthesis resulting in photosensitivity and blistering skin lesions. PCT can be triggered by certain medications, alcohol use, hepatitis C infection, HIV infection, and iron overload. Elevated urinary uroporphyrin levels confirm the diagnosis.The other answer choices do not fit with the clinical vignette. Elevated anti-Smith and anti-transglutaminase antibodies would indicate autoimmune disorders like SLE and celiac disease, respectively. A positive patch test would indicate an allergic contact dermatitis. Elevated anti-VZV antibodies would be seen in shinglesherpes zoster infection.E: Increased urinary uroporphyrin 