Trastornos de autoagresión hacia las uñas. Autoagressive nail disoreders

Haneke, Eckart (2013). Trastornos de autoagresión hacia las uñas. Autoagressive nail disoreders. Dermatologia Revista Mexicana, 57(4), pp. 225-234. medigraphic

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Background and objective: Autoaggressive nail disorders span a
wide range of clinical changes, but they often remain undiagnosed.
This article is intended to help the practitioner to make the correct
diagnosis and institute an accepted treatment.
Material and method: The patient charts of 1800 patients seen by
the author between the years 2000-2011 in 6 different European
countries were evaluated using photographs of finger and toenails.
Results: The most common condition is onycholysis induced by
overzealous manicure. The habit tic of maniacally pushing back the
proximal nail fold of one or both thumb nails is frequent and often
misdiagnosed. Heller’s median canaliform dystrophy is probably also
due to a similar injury mechanism. Onychophagia is relatively com-
mon and seen both in children and adults. Onychotillomania is less
frequent and almost exclusively seen in adults. Onychotemnomania
is even less frequent. Onychoteiromania is sowhere between the
latter two habits. Onychodaknomania is exceptional and usually a
sign of an underlying psychiatric disorder. There was no substantial
difference in the prevalence of these conditions among the different
countries visited.
Conclusions: Auto aggressive nail injury is common, but often
difficult to diagnose. Patient care requires not only an in-depth
knowledge of virtually all nail diseases, but also a cautious and
empathic patient examination and treatment

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