a 44-year-old woman comes to the clinic complaining of severe dry skin in the area over her right nipple. she denies any trauma to the area. she noticed the skin change during a self-breast examination 2 months ago. she also admits that she had felt a lump under the nipple but kept putting off making an appointment. she does admit to 6 months of fatigue but no weight loss, weight gain, fever, or night sweats. her past medical history is significant for hypothyroidism. she does not have a history of eczema or allergies. she denies any tobacco, alcohol, or drug use. examination shows a middle-aged woman appearing her stated age. inspection of her right breast reveals a scaly eczema-like crust around her nipple. underneath a nontender 2-cm mass is palpable. the axilla contains only soft moveable nodes. the left breast examination and axilla are unremarkable. what visible skin change of the breast does she have?
