I am 31 and have fought with severe cystic acne for more than ten years. What should my next steps be? (photo)

I have added a photo for a better example of what I am dealing with. They go all around my neck and last for months at a time. Itchy and painful puss filled. I have had them drained numerous times but they always come back. I have tried over the counter topicals and prescription topical ointments and pills including Accutane, nothing works! I have been told everything from changing my diet to consulting with infectious disease specialist.

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