<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 46-year-old male presents to his dermatologist for routine follow-up of his psoriasis. He was last seen in the office six months prior, at which time he started undergoing ultraviolet light therapy. He reports that he initially noticed an improvement in his symptoms but the effects were transient. He has also started noticing pain and stiffness in his fingers. His past medical history is notable for obesity and diabetes mellitus. He takes metformin. His temperature is 99F 37.2C, blood pressure is 13080 mmHg, pulse is 80min, and respirations are 16min. Multiple plaques with scaling are noted on the extensor surfaces of the upper and lower extremities. The patients physician suggests stopping the ultraviolet light therapy and starting an injectable medication that acts as a decoy receptor for a pro-inflammatory cytokine. Which of the following is an adverse effect associated with the use of this medication?? A: Reactivation of latent tuberculosis, B: Nephrotoxicity, C: Myelosuppression, D: Cushings syndrome, E: Retinopathy,  <response>: This is a clinical vignette about a 46-year-old male with psoriasis who has tried ultraviolet light therapy with transient improvement. He now has symptoms of joint pain and stiffness concerning for psoriatic arthritis. His physician recommends stopping the light therapy and starting an injectable medication that acts as a decoy receptor for a pro-inflammatory cytokine. The question asks about an adverse effect of this medication. Based on the information provided, the medication is likely a TNF-alpha inhibitor biologic medication used to treat psoriatic arthritis. A potential adverse effect of these medications is reactivation of latent tuberculosis.A: Reactivation of latent tuberculosis 