<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 15-year-old boy comes to the physician because of skin changes on his face, chest, and back over the past year. Treatment with over-the-counter benzoyl peroxide has been ineffective. Physical examination shows numerous open comedones, inflammatory papules, and pustules on his face, chest, and back. Which of the following is the most likely underlying mechanism of this patients skin condition?? A: Hyperplasia of pilosebaceous glands, B: Formation of superficial epidermal inclusion cyst, C: Hyperkeratinization of hair follicles, D: Excess androgen production, E: Type IV hypersensitivity reaction,  <response>: This is a clinical vignette describing a 15-year-old boy with acne on his face, chest and back that has not responded to over-the-counter benzoyl peroxide treatment. The description of open comedones, inflammatory papules and pustules localized to areas with high density of pilosebaceous units is classic for acne vulgaris. The most likely underlying mechanism is increased sebum production and follicular hyperkeratinization leading to plugging of the hair follicles. This process is mediated by androgens, especially testosterone, acting on the sebaceous glands during puberty. Therefore, the correct answer is excess androgen production.D: Excess androgen production 