Dermoscopic features of onychotillomania: A study of 36 cases

Publication date: Available online 14 April 2018
Source:Journal of the American Academy of Dermatology
Author(s): Austin John Maddy, Antonella Tosti
BackgroundOnychotillomania is a nail-picking disorder characterized by nail dystrophy and abnormal morphology of the nail plate, nail bed, and periungual skin.ObjectiveThe purpose of this study was to describe the dermoscopic features of onychotillomania.MethodsA 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.ResultsScales were observed in 34 cases (94.4%); absence of nail plate was seen in 30 (83.3%); wavy lines were observed in 25 (69.4%); hemorrhages were observed in 23 (63.9%); crusts were seen in 22 (61.1%); nail bed pigmentation was observed in 17 (47.2%); speckled dots were observed in 14 (38.9%); nail plate melanonychia was observed in 4 (11.1%).LimitationsLimitations included small sample size and retrospective study.ConclusionAbsence 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.

Teaser

Onychotillomania is a nail-picking disorder that is likely underreported and often misdiagnosed, The dermoscopic features of onychotillomania include scales, absence of the nail plate, wavy lines, hemorrhages, speckled dots, melanonychia, and nail bed pigmentation, Recognizing the common dermoscopic features of onychotillomania will assist the clinician in the diagnosis and management of this disorder.