<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 17-year-old high school student presents to your office for recent mood and skin changes. The patient is a high school senior who is competing on the wrestling team and recently has lost weight to drop two weight classes over the past several months. He states he has dry, cracking, and irritated skin, as well as a sensation of tingling in his hands and feet. The patient also states that he has not been feeling himself lately. He finds himself more irritable and no longer enjoys many of the activities he once enjoyed. He finds that he often feels fatigued and has trouble concentrating. The patient does not have a significant past medical history and is not on any current medications. The patient admits to drinking alcohol and smoking marijuana on special occasions. He states that he uses supplements that his other team members use. Physical exam is significant for acne, dry, cracked skin around the patients mouth in particular, and decreased sensation in his lower extremities. Laboratory values are as follows:Serum:Na: 137 mEqLCl-: 101 mEqLK: 4.1 mEqLHCO3-: 24 mEqLBUN: 15 mgdLGlucose: 79 mgdLCreatinine: 0.9 mgdLCa2: 9.2 mgdLMg2: 1.5 mEqLHomocysteine: 11.2 μmolL normal: 4.6 to 8.1 μmolLAST: 11 ULALT: 11 ULAlkaline phosphatase: 27 ULAlbumin: 4.5 gdLTotal protein: 6.9 gdLTotal bilirubin: 0.5 mgdLDirect bilirubin: 0.3 mgdLWhich of the following is the most likely diagnosis?? A: Water soluble vitamin deficiency, B: Anabolic steroid use, C: Dermatologic fungal infection, D: Depression secondary to dietary changes, E: Viral infection,  <response>: Based on the information provided in the question stem, the key findings are:- 17 year old male high school wrestler - Recently lost weight to drop weight classes- Symptoms of dry, cracked, irritated skin, tingling handsfeet, irritability, fatigue, poor concentration- Physical exam showed acne, dry cracked skin around mouth, decreased sensation in lower extremities- Lab values show elevated homocysteine levelThe history of rapid weight loss to drop weight classes along with irritability, fatigue and concentration issues could point to depression from dietary changes. However, the physical exam and lab findings do not support this. The elevated homocysteine level along with the skin and neurological findings are consistent with a deficiency in a water soluble vitamin, most likely vitamin B12. Vitamin B12 deficiency can lead to neurological symptoms and skin changes like those described. The other choices are less likely based on the information provided. There is no evidence to support anabolic steroid use, fungal infection or viral infection.A: Water soluble vitamin deficiency 