History:

 Thick scales like this can be seen in ichthyosis vulgaris but usually only in the winter months. Ichthyosis vulgaris is an autosomal dominant disorder sometimes seen with atopy and keratosis pilaris on the arms.

This thick type of scale is more commonly seen in X linked ichthyosis usually seen in males with involvement of flexural surfaces and often sparing of the palms. Flexural surfaces are spared in ichthyosis vulgaris and palms are often involved. 

Lamellar ichthyosis is an autosomal recessive scaling disorder where the scales are larger and more adherent than those in X linked ichthyosis. Facial involvement can cause marked ectropion of the eyelids. Palms and soles are involved