Nail tic disorders: Manifestations, pathogenesis and management.

Area of Science:

• Dermatology
• Psychiatry
• Behavioral Science

Background:

• Nail tic disorders represent a complex interplay between dermatological conditions and psychiatric issues.
• These disorders are characterized by body-focused repetitive behaviors with an irresistible urge, providing temporary relief.
• Despite their prevalence, nail tic disorders are understudied, with limited literature available.

Purpose of the Study:

• To review the current understanding of nail tic disorders.
• To highlight common and rare forms of nail tics.
• To discuss diagnostic and management challenges.

Main Methods:

• Literature review of nail tic disorders.
• Categorization of common nail tics: Onychophagia (nail biting), Onychotillomania (nail picking), and Habit Tic Deformity.
• Identification of uncommon and rare nail tics: Onychoteiromania, Onychotemnomania, Onychodaknomania, and Bidet nails.

Main Results:

• Onychophagia is chronic nail biting, often starting in childhood as a tension-reducing behavior.
• Onychotillomania involves recurrent nail picking, potentially causing irreversible nail matrix scarring (onychoatrophy) in severe cases.
• Nail tics can occur in psychologically normal individuals but may be linked to anxiety or obsessive-compulsive disorders.

Conclusions:

• Management of nail tics is challenging and requires a dual approach.
• Topical treatments and physical barriers (e.g., bandaging) can deter behaviors.
• Addressing underlying psychiatric comorbidities is crucial for comprehensive diagnosis and effective treatment, with medications like Fluoxetine showing potential in adults.