A thick epidermis can be site specific such as acral skin but it is also a feature of proliferative disorders such as proriasis and tumours .Hyperproliferative disorders can return to normal whereas tumous seldom do.Epidermal hyperplasia is usually seen with hyperkeratosis (thickened stratum corneum) and acanthosis (thickened spinous layer) but lichen sclerosus is an exception.
S-Squamous Eczema,Psoriasis and other psoriasiform disorders,Ichthyosis,Darier's disease,
I-Infective Tuberculosis verrucosis cutis,Atypical mycobacteria,Deep fungus,Crusted scabies,
G-Granulomatous
N-Neoplastic Epidermal neoplasms,Cutaneous horn,Angiokeratoma,Dermatofibroma,Acquired digital fibrokeratoma
D-Drugs Halogenoderma
I-Immunological Lichen sclerosus,Chronic cutaneous lupus erythematosus,
P-Physical Acral skin,Corn or callous,Radiodermatitis,
M-Metabolic Reactive perforating collagenosis,
E-Endocrine
N-Nutritional
Others Pseudoepitheliomatous hyperplasia,
Adapted from Practical Dermatopathology by Ronald Rapini. Elsevier Mosby