ABSTRACT
Nail tic disorders are fairly under-recognized and under-diagnosed nail disorders. Tic disorders are characterized by multiple sudden, rapid, recurrent, and non-rhythmic movements (motor tics) or utterances (vocal tics), or both. They fall under the category of neuropsychiatric disorders. Tic disorders pertaining to nails, also known as compulsive nail disorders, include onychophagia, habit tic deformity, onychotillomania, perionychotillomania, onychotemnomania, onychotieromania, onychodaknomania, bidet nails, and others. Onychophagia, onychotillomania, and habit tic are the most common nail tic disorders where the patient has a habit of nail biting and nail picking, respectively. Nail tic disorders are not only limited to cosmetic disfigurement of the nail, but may be associated with psychopathological states that can affect patient’s quality of life. Each such case should be addressed with a detailed history, physical examination, and psychiatric evaluation in selected cases. Diagnosis is based on history and clinical examination but histopathology may be required in special circumstances. Management includes both non-pharmacological and pharmacological modalities. Proper counseling and cognitive behavioral therapy play an important role in the management. The choice of pharmacological agent depends on the type of nail tic disorder and its severity.
