<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 9-year-old boy with a history of acute lymphoblastic leukemia is brought to the clinic by his mother because of pruritic vesicles that appeared on the left side of his torso 12 hours ago. One day earlier, before the appearance of the vesicles, the patients mother notes that he had been complaining of a burning sensation in that area. The boy has been receiving chemotherapy consisting of methotrexate, cytarabine, and cyclophosphamide for 1 month. He received the last treatment 2 days ago. He has no other past medical history. The patient is afebrile and vital signs are within normal limits. Upon physical examination, there are painful vesicles are localized to the left C7 skin dermatome see image. Which of the following is the most likely etiology of the skin lesions in this patient?? A: Viral infection of the skin, B: Reactivation of the varicella zoster virus VZV due to congenital immunodeficiency, C: Chickenpox, D: Reactivation of VZV due to immunodeficiency caused by chemotherapy, E: Bacterial infection of the skin,  <response>: This is a clinical vignette about a 9-year-old boy with a history of acute lymphoblastic leukemia who is undergoing chemotherapy and develops a vesicular rash localized to a dermatomal distribution. The key facts from the vignette are:- 9-year-old boy - History of ALL, currently on chemotherapy methotrexate, cytarabine, cyclophosphamide- Received chemotherapy 2 days ago- Developed burning sensation followed by vesicular rash in left C7 dermatome - Rash appeared 12 hours ago- No feverBased on the patients history of ALL and recent chemotherapy, as well as the unilateral vesicular rash in a dermatomal distribution, this presentation is most consistent with reactivation of varicella zoster virus VZV due to immunosuppression from the chemotherapy. VZV causes chickenpox on initial exposure, then becomes latent in dorsal root ganglia. Reactivation leads to shingles herpes zoster. Localization to a dermatome and unilateral distribution points to VZV reactivation. Immunosuppression is a known risk factor.The other options can be ruled out: - Viral infection of skin: too general, doesnt explain dermatomal rash- Congenital VZV: no history to support congenital immunodeficiency - Chickenpox: would cause more generalizedwidespread rash- Bacterial infection: vesicles not typical presentationD: Reactivation of VZV due to immunodeficiency caused by chemotherapy 