@seniormed thank you! Yes I regularly take photos of my skin issues so at my visits I can show proof of what I'm experiencing. That's what really lit the fire & prompted my PCP to refer me out to several different specialist. I have a neurologist appt this month and will be taking my diary & photos with me to help me better explain. I'm in the process of getting referral for a different rheumatologist..and at my visit with PCP at end of month I will be asking for routine labs to be drawn how ever often he feels is necessary to watch these markers. Thanks so much for your feedback.