Thinned epidermis

Thinned Epidermis                           See DX Path for details of the conditions below

This suggests partial epidermal destruction as occurs in erythema mutiforme , graft versus host disease,  lupus erythematosus, dermatomyositis and in lichen sclerosus. It can also be a feature of Degos disease. Epidermal consumption can also be a feature of melanoma.

Radiation damage gives epidermal atrophy and it is a rare feature of Sezary syndrome and Mycosis fungoides.

Erythema Multiforme

The commonest cause of epidermal thinning is ageing and sun damage but remember the regional differences in the body with eyelid skin epidermis being particularly thin relative to other areas.