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Correct: C) Viral antigen presentation leading to lymphocyte proliferation and vesicle formation in a dermatomal distribution
John presents with red, itchy, raised bumps on his hands—classic signs of varicella-zoster virus (VZV) infection, likely reactivation causing a dermatomal pattern. The key pathogenic mechanism involves the immune system recognizing viral antigens presented by infected cells, triggering cytotoxic T cells and lymphocyte proliferation, which leads to vesicular lesions in a nerve-distributed (dermatomal) pattern.
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