We thought same thing but this rheumy was highly recommended and told us she does not have an autoimmune disease and the low titer score of 1:160 did not mean she had autoimmune. He took six viles of blood and said all looked good. Our Derm --- who is also an immunologist tested biopsy for lupus and said it was not lupus --- we are so confused. Our normal life has put on hold. Back to Derm tommorrow for more biopsies. Beginning to wonder if this is going to stop. Very discouraged and an amazed how an HSV she has had for years can suddenly take control of er skin.