๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
ONYCHOTILLOMANIA
ONYCHOTILLOMANIA
Repeated manipulation of the nail apparatus can result in changes of the paronychial skin and the nail plate. Habit-tic Deformity. Caused by chronic and repetitive mechanical injury (Fig. 32-6). The cuticle is pushed back with inflammation and thickening of the proximal nail fold. Resultant nail plate presents with horizontal central riding. Occurs most commonly on thumbnail(s), caused by the index finger repeatedly picking at the cuticle of the thumbnail. Biting and repeated picking of the nail plate can also cause nail plate destruction (Fig. 32-7).
FIGURE 32-6 โข Habit-tic deformityโThe nail plates of both thumbs are dystrophic with transverse ridging and discoloration. The cuticle is absent and the proximal nail folds excoriated. When the proximal nails and nail fold were covered with tape continually, normal nails regrew in 6 months.
FIGURE 32-7 โข Compulsive nail pickingโThe cuticles are not formed, the proximal nail folds are inflamed and excoriated. The breaks in the integrity provide a portal of entry for S. aureus and acute paronychia.