<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 23-year-old primigravida pregnant patient is in her 3rd trimester with twins. She complains of itching and skin lesions. The examination shows vesicular skin lesions on the abdomen but not on the face, palms, or soles. A picture of her abdomen is shown in the image. Her past medical history is insignificant. Her vital signs are all within normal limits. What is the next best step in management?? A: Begin treatment with systemic oral corticosteroids, B: Begin weekly antepartum testing to ensure fetal well-being, C: Biopsy the lesions to ensure proper diagnosis, D: Reassure her and provide symptomatic relief with topical steroids, E: Start treatment with an antihistamine,  <response>: This is a question about managing a pregnant patient with a rash in the third trimester. Based on the description of vesicular skin lesions on the abdomen but not the face, palms or soles, this is most likely pregnancy-related pruritic urticarial papules and plaques of pregnancy PUPPP. The next best step would be to confirm the diagnosis, provide symptomatic relief, and monitor the pregnancy. A biopsy is unnecessary. Oral steroids have risks in pregnancy and antihistamines are not first-line. Fetal monitoring may be warranted if the rash is severe.D: Reassure her and provide symptomatic relief with topical steroids 