A 39-year-old woman presents for pruritic lesions of the bilateral lower extremities, as shown, without involvement elsewhere on the body. She denies joint pain, depressive symptoms, and difficulty with ambulation. She has previously tried treating the lesions with over-the-counter moisturizing cream without improvement. Which of the following is the most appropriate next step in the management of the patient?
A. Total body narrowband UVB treatment 3 times per week
B. Initiation of guselkumab injection
C. Infusion of infliximab, followed by prednisone burst as needed
D. Halobetasol 0.05% ointment twice daily to affected areas
E. Start of apremilast sample pack
