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Dermoscopic features of onychotillomania: A study of 36 cases
Austin John Maddy1, Antonella Tosti1
1Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Background:
Onychotillomania is a nail-picking disorder characterized by nail dystrophy and abnormal morphology of the nail plate, nail bed, and periungual skin.
Objective:
The purpose of this study was to describe the dermoscopic features of onychotillomania.
Methods:
A retrospective study of the dermoscopy images of 36 patients affected by onychotillomania. The images were reviewed independently by both authors and a list of dermatoscopic findings was established.
Results:
Scales were observed in 34 cases (94.4%). Absence of the nail plate was seen in 30 cases (83.3%). Wavy lines were observed in 25 cases (69.4%). Hemorrhages were observed in 23 cases (63.9%). Crusts were seen in 22 cases (61.1%). Nail bed pigmentation was observed in 17 cases (47.2%). Speckled dots were observed in 14 cases (38.9%). Nail plate melanonychia was observed in 4 cases (11.1%).
Limitations:
Limitations included small sample size and retrospective study.
Conclusion:
Absence of the nail plate with multiple obliquely oriented nail bed hemorrhages, nail bed gray pigmentation, and presence of wavy lines are characteristic findings of onychotillomania and not seen in other nail diseases.
Insights
Onychotillomania, a nail-picking disorder, often presents with absent nail plates and characteristic wavy lines. Dermoscopy reveals nail bed hemorrhages and gray pigmentation, distinguishing it from other nail conditions.
Area of Science:
- Dermatology
- Dermatopathology
- Nail Diseases
Background:
- Onychotillomania is a nail-picking disorder causing nail dystrophy and abnormal morphology.
- It affects the nail plate, nail bed, and surrounding skin.
Purpose of the Study:
- To describe the characteristic dermoscopic features of onychotillomania.
- To aid in the diagnosis and differentiation of this condition.
Main Methods:
- Retrospective analysis of dermoscopy images from 36 patients with onychotillomania.
- Independent review of images by two authors to identify key dermatoscopic findings.
Main Results:
- Absence of the nail plate (83.3%) and scales (94.4%) were common.
- Wavy lines (69.4%), hemorrhages (63.9%), and crusts (61.1%) were frequently observed.
- Nail bed gray pigmentation (47.2%) and speckled dots (38.9%) were also noted.
Conclusions:
- Absence of the nail plate, obliquely oriented nail bed hemorrhages, nail bed gray pigmentation, and wavy lines are characteristic of onychotillomania.
- These findings are not typically seen in other nail diseases, aiding differential diagnosis.
- Limitations include a small sample size and retrospective nature of the study.
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