well if you are worried about ALS -- you shouldnt have that fear as pain points away from it.I made a breakthrough myself (well on my towards a breakthrough) the other day.Instead of noticing the DIFFERENCES in my hands -- (like you I feel I have paper thin skin and feel like I can see my joints)I started looking at two things: The differences in other peoples hands (in person, on tv, in print ads)The things that are alike between one persons hands and mine (can see ligaments , thin hands, etc)it has helped alot.