What is the primary clinical manifestation in a child with scabies?

A. While osteoporosis is characterized by a negative calcium balance, this is not a major complication itself. It's a contributing factor to the condition.
B. Loss of estrogen is a risk factor for osteoporosis, especially in postmenopausal women. However, it's not a complication of the disease itself.
C. Dowager's hump, or kyphosis, is a common symptom of osteoporosis, but it's not a major complication. It's a visible manifestation of the disease.
D. Bone fractures are the major complication of osteoporosis. The weakened bones become more susceptible to fractures, especially in areas like the hip, spine, and wrist.

A. Herpes simplex virus (HSV) is not directly linked to an increased risk of esophageal cancer. While it can cause infections in the esophagus, especially in immunocompromised individuals, it is not recognized as a significant risk factor for esophageal cancer itself.
B. While some individuals may experience discomfort from spicy foods, there is no substantial evidence linking the consumption of spicy foods directly to the development of esophageal cancer. Dietary factors are more complex, and spicy foods are not typically identified as a primary risk factor.
C. Gastroesophageal reflux disease (GERD) is a significant risk factor for esophageal cancer, particularly adenocarcinoma. Chronic reflux can lead to changes in the esophageal lining (Barrett's esophagus), which is a precancerous condition. Therefore, this is a well-established risk factor.
D. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is not considered a direct risk factor for esophageal cancer. In some contexts, NSAIDs may even have a protective effect against certain types of cancer due to their anti-inflammatory properties. However, chronic use can lead to gastrointestinal complications, including ulcers, but does not have a clear link to the development of esophageal cancer.