Onychophasia - A case report

Authors

1. Salman Salaria
   Resident Physician, Delaware Psychiatric Center, Delaware & Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, US
2. Smit Shah
   MS-3, Rutgers Robert Wood Johnson Medical School, New Jersey, US
3. Pooja Shah
   Resident Physician, Delaware Psychi-atric Center, Delaware, US
4. Osman Salaria
   Resident Physician Mount Sinai Medical Center of Florida, Florida, US

Abstract

Body focused repetitive behaviors are frequently seen in individuals with obsessive compulsive disorders. These behaviors range from repetitive hand washing to more severe forms such as onychophagia. We report a case of severe onychophagia wherein the patient despite receiving pharmacological treatment for obsessive compulsive disorder was unable to control her impulse to compulsively bite her nails. Repetitive nail biting led to the patient being treated for bacterial infections, debridement and subsequent digital amputations. Cases of severe onychophagia are seldom seen in clinical practice therefore an awareness regarding early identification of the signs and symptoms and up to date management are crucial for practicing clinicians. As illustrated in this case report, pharmacotherapy as well as intense psychotherapy is essential for the long-term effective management of this chronic ailment that can gravely affect the quality of an individual's life.

Keywords

Onychophagia, nail biting, obsessive compulsive disorder, Onychtillomania.

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