Review Question - QID 216651

A 48-year-old woman presents to the clinic with a rash on her right nipple that she first noticed 6 months ago when she started wearing a new type of sports bra. She reports that her nipple is very dry and scaly, and she has tried lotions and steroid creams with minimal improvement. The lesion has also become more irritated and occasionally bleeds, causing her pain and pruritus. She has a history of asthma and contact dermatitis. Her temperature is 98.2°F (36.8°C), blood pressure is 115/72 mmHg, pulse is 66/min, respirations are 13/min, and oxygen saturation is 99% on room air. On exam, there is a lesion of the right nipple as shown in Figure A. No underlying mass is palpated. Which of the following is the most likely diagnosis?