A 24-year-old man presents with progressive burning pain in his hands and feet worsening with exercise. Vital signs show BP 138/88, HR 98, RR 16, temp 37°C, SpO2 98%. He has clusters of dark red papules over the lower trunk and markedly decreased sweating. Urinalysis reveals proteinuria; serum creatinine is normal. He denies fever or recent infections. Which enzyme deficiency most likely explains these findings?

1. A)Alpha galactosidase AGABARITO
2. B)Hexosaminidase A
3. C)Beta glucocerebrosidase
4. D)Iduronidase
5. E)Sphingomyelinase