Positive skin punch biopsy - what's next?

Hi, I'm a 26M, healthy overall, and just today receive a positive skin punch biopsy diagnosis. It's all over my body, and it comes in flares. It first started in October 2024 after having COVID, about a month later. I had no clue what it was, doctors had no ideas so they sent me for a brain MRI to rule anything out. It lasted for about a month badly, then went away and came back in flares for a few more weeks. Then for most of 2025, it was completely gone. Fast forward to Dec 2025, I got sick again, and then in January the itching / pricking and burning came back. It went away, but then I started going to gym and working out about a month ago and it came back full force, just as bad as the first time around that I had this.

My neurologist suggested it could be SFN from COVID so sent me for a skin punch biopsy, and surprisingly came back positive at both sites. According to the report, "showed significant loss, (with < 5/linear mm in both) of intraepidermal nerve fibers).

Even these past few weeks, it'll completely go away and then come back. I've been tested for pretty much everything that can cause it, diabetes, autoimmune diseases, all negative. I haven't had MCAS ruled out so I've been looking into that. Has anyone else experienced the same thing as me and had a positive biopsy, but ended up fully recovering? Any insight is very appreciated, thank you. I'm really nervous about this diagnosis and can't stop worrying if I'm gonna have this for the rest of my life.