Biopsies a good way to start. I only had one which was negative, doc said it is based on the if the GD is active. I still had rash at the time going on almost a year, but no new bumps for a few months. Didn't bother with another biopsy as I clearly have the disease. If anyone it unsure the cilantro smoothie is a must try and also I believe the Witch Hazel is a cheap way to control the bacteria.