Hi Barb, Eczema is a real possibility, especially if those “spikes” are toward the skin side (not the air side). When toward the skin side, those “spikes” may be scaling down into the hair follicles. It’s hard to tell, but if the spikes are on the AIR side, that would be more indicative of some strange fungus or what not. I would think the dermatologist could have ruled out fungi because that is a dramatic presentation when biopsied — an easy diagnosis. Eczema is a broad diagnosis — there are SO MANY forms and manifestations, and it can be chronic — a real bear to treat effectively, sadly.