A 16-year-old girl presents to dermatology with a 6-month history of facial acne consisting of comedones, inflammatory papules, and pustules distributed across her forehead, cheeks, and chin. Vital signs are normal. Physical examination reveals open and closed comedones with surrounding erythema and edema. A skin biopsy of an inflamed lesion is obtained. Microscopic examination demonstrates follicular plugging with lamellated keratin, sebaceous gland hyperplasia, and Cutibacterium acnes colonization within the follicle. Serum testosterone and other androgens are within normal limits for her age. Which of the following histopathologic findings is the primary pathogenic mechanism in acne vulgaris?

1. A)Lymphocytic infiltration and granulomatous inflammation in the dermis surrounding the follicle
2. B)Hyperkeratinization of the follicular epithelium with retention of cornified materialGABARITO
3. C)Vasculitis and endothelial damage within dermal blood vessels adjacent to sebaceous glands
4. D)Fibrosis and permanent loss of dermal collagen architecture
5. E)Sebaceous gland enlargement with increased lipid production independent of androgen sensitivity