<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 39-year-old male presents to your office with nodular skin lesions that progress from his right hand to right shoulder. The patient reports that the initial lesion, currently necrotic and ulcerative, developed from an injury he received while weeding his shrubs a couple weeks earlier. The patient denies symptoms of respiratory or meningeal disease. Which of the following most likely characterizes the pattern of this patients skin lesions:? A: Contact dermatitis, B: Hematogenous dissemination, C: Dermatophyte colonization, D: Ascending lymphangitis, E: Arthropod bite,  <response>: This is a question about identifying the pattern of skin lesions in a patient. Based on the description, the lesions started from an injury on the right hand, and have progressed up the arm to the right shoulder. This pattern of spread from a local site up the lymphatic drainage suggests ascending lymphangitis. Contact dermatitis and arthropod bites would be localized to the site of contactbite. Hematogenous dissemination and dermatophyte colonization would not follow this ascending pattern.D: Ascending lymphangitis 