Onychotillomania: An underrecognized disorder

Onychotillomania: A Chameleon-Like Disorder: Case Report and Review of Literature

“…This habitual disorder may lead to profound shortening, distortion, and, in severe cases, complete extraction of the nail plate as well as onychoatrophy, due to permanent damage of the nail matrix. The majority of nail pickers use their own fingers/nails to manipulate other digits, albeit sharp instruments, from scissors to knives or toothpicks, can be employed for excessive grooming [1][2][3].…”

“…It is specifically delineated by recurrent and overwhelming picking and manicuring of the nail unit, with the fingers or tools, resulting in notable onychodystrophy and, in severe cases, onychoatrophy. It may also be complicated by infections and/or paronychia [1][2][3]. This nail picking pattern has been classified among the field of psychocutaneous ailments, owing to its high predisposition to concomitantly manifest with neuropsychiatric comorbidities or other behavioral disorders [4][5][6][7].…”

“…Taken together, all these parameters may entail underrecognition, misdiagnosis, and inadequate therapeutic approach of onychotillomania, hence highlighting the pivotal role of clinicopathological confrontation towards establishment of a solid differentiation and diagnosis [2,3].…”

“…Although benign nail picking is common in the general population [8], a small fraction of patients experience significant disability due to the habitual disorder [2,6]. Despite the incremental scientific interest in the concept of BFRBDs, onychotillomania has not been explicitly studied in respect to clinicopathologic features, associated comorbidities, and effective treatment modalities.…”

Alopecia Areata and Habit Tic Deformities

“…N-acetyl cysteine or antidepressant selective serotonin reuptake inhibitors may be effective as habit tic deformity may be related to obsessive-compulsive behaviors. However, evidence for these modalities in the treatment of self-induced nail disorders is lacking [7]. …”