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Onychotillomania (onychophagia, habit tic, median canaliform onychodystrophy)
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Habit-tic deformity is a nail dystrophy found usually on both thumbnails, and very seldom on toenails. Patients are usually unaware of doing such a repetitive trauma of the proximal nail fold and as a result of the underlying nail matrix. Nails in such a condition are described as “washboard nails” due to their resemblance to a washboard (Figure 6.6).
Nails
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Causes when a single nail is affected: Median nail dystrophy looks like an upside down Christmas tree. It is a temporary abnormality and gets better spontaneously after a few months. The cause is unknown.Habit tic deformity. Here, there is a broader groove made up of numerous concave transverse ridges. It is due to picking or biting the cuticle which damages the nail plate as it grows out.A single wide grove may be due to myxoid cyst or fibroma over the posterior nail fold which presses on the underlying matrix (see p. 332).
Onychotillomania
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
While traditionally separated from other behavioral disorders of the nail unit, onychotillomania can be conceptualized as an umbrella term, with many shared and some contrasting features with other self-induced nail disorders such as habit tic deformity, onychophagia, and median nail dystrophy (Figure 18.1). Habit tic deformity is a variant of onychotillomania that results from compulsive rubbing of the thumbnail and proximal nail fold by the adjacent index finger, causing horizontal ridges and depressions (Figures 18.2 through 18.4). Other self-induced nail disorders include onychophagia (biting or chewing of the distal nail plate and nail folds) and median nail dystrophy (repeated manipulation of cuticle and nail fold resulting in a midline, longitudinal canal formation or split) (Figure 18.2). Self-inflicted nail disorders have traditionally been categorized as a subset of traumatic nail abnormalities, but occur independently of external insults.1 A novel classification scheme of onychotillomania was proposed in 2015 to encompass all self-induced nail disorders.2 Although relatively misunderstood, these disorders are thought to be associated with underlying psychological dysfunction or psychiatric disease, and may be better classified as body-focused repetitive behaviors (BFRBs).3–7
Biotin for the treatment of nail disease: what is the evidence?
Published in Journal of Dermatological Treatment, 2018
Shari R. Lipner, Richard K. Scher
Habit tic deformity of the nail usually happens due to repeated manipulating and rubbing of the cuticle and proximal nail fold with another digit. Patients may be unaware of this behavior, however in many cases, they become more conscious when probed. Clinically, there is a midline furrow longitudinally, with numerous parallel transverse ridges (42). While any nail may be affected, the thumbnails are most commonly involved. Treatment options include occlusive dressings, cyanoacrylate adhesives, cognitive behavioral therapy, as well as psychotropic medications with varying successes (43).