Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. * As per my clinical experience, the underlying cause is not sorted out till now and that is the reason for agony of the condition. * The cause may be trace elements alterations as zinc, selenium, copper or others ; genetic problems ; biochemical alterations ; intestine flora disturbances giving secondary skin lesions. * I would recommend a clinical examination in my office, before proceeding for further comments. Hope I have answered your query. Let me know if I can assist you further.