<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 56-year-old man presents to his primary care provider because of a lack of flexibility in his right hand. He has noticed that his hand has become less flexible and more fixed over the past year and he now has trouble shaking other peoples hands comfortably. He has a history of chronic alcohol abuse, hepatitis C, and cirrhosis. His family history is insignificant. He has a 40 pack-year smoking history. At the physicians office, his blood pressure is 11867 mm Hg, the respirations are 18min, the pulse is 77min, and the temperature is 36.7C 98.0F. On physical examination, the 4th and 5th digits are mildly flexed with dense, rope-like cords extending down his palm. Additionally, small ulcerations are identified on his palm. Which of the following is considered the first-line therapy for this condition?? A: Surgery, B: Colchicine, C: Anti-TNF drugs, D: Steroid injections, E: Collagenase injections,  <response>: This is a clinical vignette describing a patient with symptoms and signs consistent with Dupuytrens contracture, including lack of flexibility and fixed contracture of the hand, rope-like cords in the palm, and small ulcerations. The question asks about first-line therapy for this condition. Dupuytrens contracture is caused by fibrosis of the palmar fascia leading to contractures of the fingers. First-line therapy is collagenase injections, which can help break down the collagen cords and improve flexibility. Surgery may be considered for more severe contractures not responsive to collagenase. Colchicine and anti-TNF drugs may help with inflammation but are not first-line. Steroid injections are also not typically first-line.E: Collagenase injections 