Could Small, Red Dots On Nipple And Itching Be Due To Pagets Disease?

I ve got small red dots on my left nipple for some months now. They are a little bit itchy. The nipple has became darker and it's quite red as well. I've been to ultrasound scan and mammography (there seemed to be nothing wrong) as well and consulted two gynecologists and one dermatologist. Dermatologist gave me antiobiotic liquid and cortisone which didnt help. The nipple is not scaly at all nor "wet" and it doesnt look like a eczema. It looks like as if the structure of the nipple had changed somehow. Do I have to worry that this is Pagets disease or it there any other possibilities? I am 40-year old.