<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 65-year-old woman comes to the clinic for an annual well-check. Her past medical history includes diabetes and hypertension, which are well-controlled with metformin and losartan, respectively. The patient reports a healthy diet consisting of mainly vegetables and lean meat. She denies smoking or alcohol use. She enjoys taking walks with her husband and sunbathing. Physical examination is unremarkable expect for a rough, scaly, sand paper-like plaque on her left dorsal hand with no tenderness or pain. What is the most likely diagnosis?? A: Actinic keratosis, B: Psoriasis, C: Rosacea, D: Seborrheic keratosis, E: Sunburn,  <response>: This is a question about diagnosing a skin condition in an older adult woman based on her history and physical exam findings. The key details are her age of 65 years old, history of well-controlled diabetes and hypertension, overall healthy lifestyle except for sunbathing, and the rough scaly plaque found on exam of her left hand. This plaque is asymptomatic and found on a sun-exposed area. Given her age and sun exposure history, the most likely diagnosis is actinic keratosis, which are rough scaly lesions on sun-exposed skin that can progress to squamous cell skin cancer. Psoriasis, rosacea, seborrheic keratosis, and sunburn are less likely based on the clinical vignette.A: Actinic keratosis 