Self-Induced Nail Disorders: Clinical and Demographical Features.

Area of Science:

• Dermatology
• Psychiatry
• Behavioral Science

Background:

• Self-induced nail disorders (SINDs) are pathological grooming habits damaging nails and surrounding structures, classified as a subset of body-focused repetitive behaviors (BFRBs).
• Limited data exist on the demographic and clinical characteristics of SINDs, despite their prevalence and potential psychological impact.

Purpose of the Study:

• To investigate the demographic and clinical characteristics of patients diagnosed with SINDs.
• To understand the prevalence of SIND subtypes and associated BFRBs.
• To explore factors influencing treatment-seeking behavior in SIND patients.

Main Methods:

• A multicenter prospective cohort study involving 675 patients diagnosed with SINDs.
• Data collection included demographics, SIND subtypes, associated BFRBs, psychiatric history, and family history.
• Patients were categorized into six SIND subgroups, with ethical committee approval obtained.

Main Results:

• The mean age of SIND onset was 16.6 years; no significant gender difference was observed for SIND onset.
• 47% of patients had multiple SIND subtypes, and 45.4% had other BFRBs, most commonly cheek/lip biting and acne excoriée.
• Females showed higher rates of co-occurring BFRBs (54.5% vs. 31.2%). Only 19.1% sought medical treatment, though 56.0% felt severe discomfort. Treatment seeking was higher in those with psychiatric disorders or family history of BFRBs.

Conclusions:

• Self-induced nail disorders often coexist with other BFRBs, with a higher prevalence in females.
• Despite awareness of their habits, patients exhibit a low rate of seeking medical treatment for SINDs.
• Dermatologists are crucial for identifying SINDs, managing associated behaviors, and coordinating care for comorbid psychiatric conditions.