Review Question - QID 213837

A 43-year-old woman presents to her primary care physician with a nipple rash she has had for 4 months. She reports that her left nipple is very dry and scaly. She has tried using petroleum jelly and hydrocortisone cream with minimal improvement. The patient has a history of asthma and hypertension. She uses an albuterol inhaler as needed and was started on hydrochlorothiazide 6 months ago. Her aunt had breast cancer that was BRCA1 mutation-positive. On physical examination, a lesion on the left nipple is appreciated, as shown in Figure A. A shave biopsy is performed that shows cells with pale cytoplasm and large nuclei that are scattered individually throughout the epidermis. Which of the following is the most likely diagnosis?