It's cause by imbalance in enzymes in dermis and epidermis get these checked in your book celiac is intolerance to gluten. I was born with this disease I'm 50 nothing to do with food and lupus affects liver experts discovered this disease from HIV liaisons are same hence it been classed auto immune disease it's normal we get routine tests for hepatitis, hiv etc in our bloods is routine but we can't spread or catch it that's how docs discovered it bout 15 yr ago

I am seeing a psychiatrist and counselor. Family doctor suggested it to at least try and lower the stress of this. Nothing prescribed yet!

One of the 9 Dermas did test me for Celiac Disease and Lupus which waiting for the results added stress to my normal stress, but luckily, they came back negative, but Derma was the one that suggested I go to a psychotherapist, hmm! Too bad she didn't get to the root of the real problem!

I am trying to leave no stone unturned! I just don't feel my dermatologist has explored enough. He is probably right about the pn, but I need to do this. All members of my family, medical problems, and for an accurate diagnosis, nightmare.