Clinical and dermoscopic characteristics of onychophagia and onychotillomania: a retrospective study of 63 cases

Chen, Yusha; Pradhan, Sushmita; Lyu, Ling; Xue, Siliang

doi:10.1111/ced.15057

Cited by 5 publications

(9 citation statements)

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“…Alternatively, there are several approaches that do not involve oral medications. However, for some individuals, pharmacologic agents may be helpful [ 3 , 4 , 9 , 10 , 12 , 13 , 15 , 16 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Onychotillomania describes recurrent picking of the nails [ 5 , 12 , 19 , 20 ]. However, several investigators have broadened the definition of this condition to include repetitive picking, pulling, and excessive manicuring of the entire nail unit; hence, they consider habit-tic nail deformity to be a variant of onychotillomania [ 5 , 6 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since the nail picker may also have other repetitive behaviors (such as habit-tic nail deformity, onychophagia, skin biting, and/or skin picking) additional findings may include central furrow with transverse parallel ridges, cuticle loss, macrolunula, melanonychia, nail bed exposure, nail fold hyperpigmentation, nail fold and hyponychium trauma (presenting as acute and/or chronic paronychia, erythema, erosions, and excoriations), nail plate atrophy or absence, nail plate shortening, pterygium formation, and subungual hematoma. In addition to bacterial and candida infections of the nail fold, onychotillomania can make the affected digit susceptible to viral infections (such as herpetic whitlow caused by herpes simplex virus, verruca vulgaris caused by human papillomavirus, and molluscum contagiosum caused by pox virus) [ 5 , 6 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The nails are abnormally short and the distal edges are uneven, with or without horizontal splitting of the nail plate (which is referred to as lamellar onychoschizia); in severe cases, biting occurs past the nail bed, or the nail is absent or both. The cuticles may be ragged or absent and the nail folds may also be dystrophic; although some investigators elect to consider these to be changes of onychophagia, other researchers more appropriately classify these findings as a concurrent occurrence of other body-focused repetitive disorders such as skin picking and skin biting [ 4 , 10 , 12 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The latter include cognitive behavioral therapy, habit-reversal therapy, stimulus control procedures and occlusive barriers. Indeed, some researchers recommend combining psychotherapies [5,6,[12][13][14][15]19,20].…”

Section: Figure 7: Nail Unit Anatomymentioning

confidence: 99%

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Nail-Associated Body-Focused Repetitive Behaviors: Habit-Tic Nail Deformity, Onychophagia, and Onychotillomania

Cohen¹

2022

Cureus

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Habit-tic nail deformity, onychophagia (also referred to as nail biting) and onychotillomania (also referred to as nail picking) are body-focused repetitive behaviors that can involve the nails and periungual skin. Patients with habit-tic nail deformity are typically unaware that repeatedly using their nail, often the adjacent index finger, to rub the proximal nail fold and its underlying matrix -usually of one or both of their thumbnails -is the cause of the longitudinal depressed groove that extends along the entire the nail plate. Nail biters usually bite multiple nails -most commonly on the digits of the hands -and the patient is cognizant of their behavior. However, the term onychophagia is a misnomer and onychodaxia would be a more appropriate nomenclature. Nail pickers also often realize that their dystrophic nail results from using other nails or tools to pick, pull, or excessively manicure the affected nail. Individuals with habit-tic nail deformity or onychophagia or onychotillomania may concurrently have other repetitive behaviors involving the skin or the hair or both. Three patients with a nail-associated body-focused repetitive behavior are described who not only presented with dystrophy of their nails but also abnormalities of the adjacent nail apparatus: a 36-year-old woman with habit-tic nail deformity and dermatodaxia, a 64-year-old man with biting of both the nails and the skin, and a 63-year-old man with nail picking and skin picking. The nail dystrophy and concurrent skin biting or skin picking were not the issues that prompted the reported patients to seek evaluation by a physician; the body-focused repetitive behaviors of the nails and skin were incidental findings during their cutaneous examination. The management of nail-associated body-focused repetitive behavior may include non-pharmacologic treatments (such as physical modalities and behavior modifications) and/or pharmacologic agents. The reported woman with habit-tic nail deformity was willing to consider an attempt to modify her repetitive behavior by using paper tape as a physical modality to cover the area on her thumbs that she would unconsciously rub. However, similar to the men in this report with onychophagia and onychotillomania, many of the patients with nail-focused repetitive behaviors do not want to initiate any interventions that might decrease or eliminate their nail condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figure 7: Nail Unit Anatomymentioning

confidence: 99%

See 3 more Smart Citations

Nail-Associated Body-Focused Repetitive Behaviors: Habit-Tic Nail Deformity, Onychophagia, and Onychotillomania

Cohen¹

2022

Cureus

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Self-induced nail disorders (SINDs): What do we know so far?

Starace,

Cedirian,

Alessandrini

et al. 2023

Annales de Dermatologie et de Vénéréologie

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Dermatologic aspects of onychophagia

Gosteva,

Saraniuk

2024

Vestnik dermatologii i venerologii

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Onychophagia is a psychiatric disorder manifested by compulsive, repetitive biting of nail plates. To date, the etiopathogenesis of the disease remains incompletely understood. The leading role in the development of this condition is attributed to concomitant mental disorders. Nevertheless, onychophagy today is a complex interdisciplinary problem that requires the involvement of doctors of various specialties. Dermatologists are no exception. Clinical evaluation of nails in onychophagia by a dermatologist is important both in terms of diagnosis and possible ways of correcting pathologic changes in nail plates. This article provides up-to-date information on onychophagia with an emphasis on the dermatologic aspect of the disorder.

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Clinical and dermoscopic characteristics of onychophagia and onychotillomania: a retrospective study of 63 cases

Abstract: Com, combined group; OP, onychophagia; OT, onychotillomania. a Calculated by v² test or Fisher exact test as appropriate, with statistical significance set at a P < 0.05; significant values shown in bold.

Cited by 5 publications

References 5 publications

Nail-Associated Body-Focused Repetitive Behaviors: Habit-Tic Nail Deformity, Onychophagia, and Onychotillomania

Nail-Associated Body-Focused Repetitive Behaviors: Habit-Tic Nail Deformity, Onychophagia, and Onychotillomania

Self-induced nail disorders (SINDs): What do we know so far?

Dermatologic aspects of onychophagia

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