<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 16-year-old boy is brought to the physician by his host parents for evaluation of a progressively pruritic rash over his shoulders and buttocks for the past 6 months. He recently came to the United States from Nigeria to attend a year of high school. He reports that it has been increasingly difficult for him to read the whiteboard during classes. Physical examination shows symmetrically distributed papules 48 mm in diameter, excoriation marks, and patchy hyperpigmentation over his shoulders, waist, and buttocks. There is nontender inguinal lymphadenopathy and several firm, nontender subcutaneous nodules along the right iliac crest. Six skin snip biopsies are taken from the pelvic girdle, buttocks, and thigh, and are then incubated in saline. After 24 hours, microscopic examination shows motile microfilariae. Which of the following is the most likely diagnosis?? A: Lymphatic filariasis, B: Onchocerciasis, C: Trichuriasis, D: Cysticercosis, E: Cutaneous larva migrans,  <response>: This is a clinical vignette describing a 16-year-old boy who recently came to the US from Nigeria and is presenting with a pruritic rash, difficulty seeing the whiteboard, lymphadenopathy, and subcutaneous nodules. A skin snip biopsy shows motile microfilariae. The key findings here are:- Recently immigrated from Nigeria- Pruritic rash and skin findings consistent with onchodermatitis- Visual issues suggestive of eye involvement- Biopsy showing motile microfilariaeThis clinical presentation is most consistent with onchocerciasis, which is caused by the filarial nematode Onchocerca volvulus. It is transmitted by black flies and endemic in parts of Africa, including Nigeria. The motile microfilariae migrate to the skin and eyes, causing the characteristic rash, visual changes, and eye disease. Lymphatic filariasis and loiasis can also cause skin manifestations with microfilariae but the eye and vision involvement point more specifically to onchocerciasis.B: Onchocerciasis 