Hi @ericy210

...this is a bit in WAG (wild ars guess) territory

To pursue the autoimmune angle, might you consult a vasculitis dermatologist or a rheumatologist who sees cutaneous vasculitis patients?

I wonder if the ringed white areas on the tops of your feet are related to livedo reticularis/racemosa

If you decide to investigate “vasculitis dermatologists,” might you be near one of the experts that co-authored this paper https://pubmed.ncbi.nlm.nih.gov/29136340/