<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 40-year-old woman comes to the physician for the evaluation of a 4-month history of reddening of the nose and cheeks. She has no itching or pain. She first noticed the redness while on a recent holiday in Spain, where she stayed at the beach and did daily wine tastings. She has tried several brands of sunscreen, stopped going outside in the middle of the day, and has not drunk alcohol since her trip, but the facial redness persists. She has no history of serious illness. Her younger sister has acne vulgaris, and her mother has systemic lupus erythematosus. The patient reports that she has had a lot of stress lately due to relationship problems with her husband. She does not smoke. Her vital signs are within normal limits. Examination shows erythema of the nose, chin, and medial cheeks with scant papules and telangiectasias. There are no comedones or blisters. The remainder of the examination shows no abnormalities. In addition to behavioral modifications, which of the following is the most appropriate initial treatment?? A: Topical corticosteroids, B: Topical benzoyl peroxide, C: Oral isotretinoin, D: Oral hydroxychloroquine, E: Topical metronidazole,  <response>: This is a clinical vignette describing a 40-year-old woman with a 4-month history of facial redness involving the nose, cheeks, and chin. Key findings on history and physical exam are persistent facial erythema, papules, and telangiectasias in a photodistribution pattern, without comedones or blisters. The differential diagnosis includes rosacea, seborrheic dermatitis, lupus malar rash, and photosensitivity reaction. However, the description of papules and telangiectasias in the central face without comedones or blisters is most consistent with rosacea. Topical metronidazole is a topical antibiotic and anti-inflammatory medication that is commonly used as initial treatment for the papules and erythema of rosacea. Topical corticosteroids can worsen rosacea and induce steroid rosacea. Topical benzoyl peroxide is used for acne vulgaris but not rosacea. Oral isotretinoin is used for severe, recalcitrant rosacea. Oral hydroxychloroquine is used for lupus, which is less likely here.E: Topical metronidazole 