Thanks for posting your query at DoctorSpring.com. I can understand your concern.
You seem to be having phrynoderma which is caused due to vitamin A deficiency. The thickened skin will slowly heal up on taking supplements of vitamin A. You will need to visit your doctor for a prescription of vitamin A 25000 IU. You can apply tretinoin cream on the affected areas in order to aid the healing.
Please let me know if you have any queries.
Patient replied :
Thank you for your answer. From what I've read that is not common in western societies with healthy diets..could there be another cause, perhaps lichen notidus or exzema?
my son eats a fairly healthy diet and also takes vitamins.
sometimes it gets better with cream or cortizone creams.
Here is a picture again
Thanks for posting your reply.
I can understand your concern about the vitamin A deficiency. The other possible diagnosis is lichen spinulosus which is a slight derangement of keratinization. The treatment for it would be the same as that of phrynoderma.