Habit tic nail deformity - a rare presentation in an 8 year old boy

Habit tic nail deformity is a nail dystrophy resulting from habitual, repetitive trauma to the nail. It is usually acquired in adulthood, however, we report a case of habit tic nail deformity in an 8 year old boy. The diagnosis was made clinically with further history revealing that the boy repeatedly rubbed his thumbnails and pushed the cuticles. Emollient cream (Balneum®) was recommended twice daily and both the patient and his mother were educated on the behavioral nature of this condition. There was marked improvement at 6 months of treatment and further improvement at 12 months.We note that habit tic nail deformity is not exclusive to adults. Diagnosis can be made clinically. History and physical examination provide valuable clues and psychosocial links must be explored and addressed. Management is challenging and compliance with treatment is variable. Patient education, barrier methods, and behavioral therapy can be helpful in preventing further trauma to the nails.