Onychotillomania

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Onychotillomania
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Onychotillomania is a compulsive behavior in which a person picks constantly at the nails or tries to tear them off. [1] It is not the same as onychophagia, where the nails are bitten or chewed, or dermatillomania, where skin is bitten or scratched. Onychotillomania can be categorized as a body-focused repetitive behavior in the DSM-5 and is a form of skin picking, also known as excorciation disorder.

Contents

It can be associated with psychiatric disorders such as depressive neurosis, delusions of infestation [2] and hypochondriasis. [3]

It was named by Jan Alkiewicz, a Polish dermatologist. [4]

The constant destruction of the nail bed leads to onychodystrophy, paronychia [5] and darkening of the nail. [6]

Some cases have been treated successfully with antipsychotics. [7]

One cheap solution suggested by researchers is to cover the proximal nail fold with a Cyanoacrylate glue. "The mechanism of action for improvement is probably related to the presence of an obstacle to picking." [8]

See also

Related Research Articles

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Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen.

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<span class="mw-page-title-main">Nail biting</span> Medical condition

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Dermatophagia or dermatodaxia is a compulsion disorder of gnawing or biting one's own skin, most commonly at the fingers. This action can either be conscious or unconscious. Those affected with dermatophagia typically bite the skin around the nails, leading to bleeding and discoloration over time. Some people also bite on their skin on their finger knuckles which can lead to pain and bleeding just by moving their fingers. In herpetology, dermatophagia is used to correctly describe the act in which amphibians and reptiles eat the skin they shed, but this is not what occurs in humans. Those diagnosed with this disorder do not develop wounds on the bitten areas of their hands or lose any skin. Instead, they experience a thickening of the skin being repeatedly bitten. Contemporary research suggests a link between impulse-control disorders and obsessive–compulsive disorders, and this was addressed in the DSM-5 when dermatophagia and other related disorders were classified as 'other specified obsessive-compulsive related disorders' and are given the specification of body focused repetitive behavior. Further information on OCD, other anxiety disorders, dermatophagia and other related body focused repetitive behaviors can be found in the DSM-5.

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<span class="mw-page-title-main">Psoriatic onychodystrophy</span> Medical condition

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References

  1. James WD, Berger T, Elston D (2006). Andrews' Diseases of the Skin: Clinical Dermatology (10th ed.). Philadelphia: Saunders Elsevier. ISBN   978-0-7216-2921-6.
  2. Ameen Sait M, Reddy BS, Garg BR (1985). "Onychotillomania. 2 case reports". Dermatologica. 171 (3): 200–2. doi:10.1159/000249420. PMID   4076493.
  3. Kim MH, Park HJ, Lee JY, Cho BK (July 2006). "Two Cases of Onychotillomania". Korean J Dermatol (in Korean). 44 (7): 855–857. ISSN   0494-4739.
  4. Grzybowski A, Zaba R (2009). "Professor Jan Alkiewicz, MD, and his influence on 20th century dermatology and mycology". Clinics in Dermatology . 27 (3): 317–322. doi: 10.1016/j.clindermatol.2008.10.009 . PMID   19368061.
  5. Harth W, Gieler U, Kusnir D, Tausk F (2009). Clinical Management of Psychodermatology. Berlin: Springer. p. 21. ISBN   978-3-540-34718-7.
  6. Baran R (1990). "Nail biting and picking as a possible cause of longitudinal melanonychia. A study of 6 cases". Dermatologica. 181 (2): 126–8. doi:10.1159/000247900. PMID   2242780.
  7. Hamann K (1982). "Onychotillomania treated with pimozide (Orap)". Acta Derm. Venereol. 62 (4): 364–366. PMID   6183881.
  8. Ring DS (November 2010). "Inexpensive solution for habit-tic deformity". Archives of Dermatology. 146 (11): 1222–3. doi: 10.1001/archdermatol.2010.287 . PMID   21079056.