Choice A rationale:

 The presence of redness, swelling, and tenderness.

Rationale: Closed comedones, also known as whiteheads, are non-inflammatory lesions that do not exhibit redness, swelling, or tenderness.

These lesions are characterized by the accumulation of sebum and dead skin cells within hair follicles, which form a white or flesh-colored plug that is not associated with inflammation.

Choice B rationale:

 Closed comedones (whiteheads).

Rationale: Closed comedones, or whiteheads, are commonly observed in non-inflammatory presentations of acne vulgaris.

These lesions occur when hair follicles become blocked with sebum and dead skin cells, leading to the formation of a white or flesh-colored plug.

Unlike inflammatory lesions, whiteheads do not exhibit redness, swelling, or tenderness.

Choice C rationale:

 Nodules and cysts.

Rationale: Nodules and cysts are typically observed in severe cases of acne vulgaris and represent inflammatory lesions.

These lesions are characterized by deep, painful, and often pus-filled nodules or cysts beneath the skin's surface.

They are not commonly associated with non-inflammatory presentations.

Choice D rationale:

 Papules and pustules.

Rationale: Papules and pustules are also inflammatory lesions seen in acne vulgaris.

Papules are small, raised, red bumps, while pustules are similar but contain pus.

These lesions are associated with redness, swelling, and tenderness, which are not characteristic of non-inflammatory lesions.