I've had crushing fatigue, disordered sleep and brain fog for over 20 years. I believe dermatitis [severe at first, now persistent and hard to keep under control] to be the "stressor" Martin Pall talks about, or the "fuse blower" you do.
Does this sound likely?
The dermatitis is likely to be simply one more symptom of an underlying process contributing to the fatigue, rather than the cause. I would see what the dermatologist says, and do the SHINE option. My assistant and I do phone consultations, which you may want to consider as well (you can email firstname.lastname@example.org for more information or to schedule a consultation).