A 25-year-old man developed these changes on both thumbs over 1 year. After gently explaining the cause, I placed a small circular "dot" bandage over the proximal nail fold of each nail in the office. I then asked the patient to wear them for 3 days (change daily) to bring any rubbing or picking to a conscious level--thus helping him to stop.

HABIT TIC DEFORMITY

Chronic picking of the proximal nail fold of the thumb by the index finger can cause a dystrophy of the nail. Multiple transverse lines resembling a wash board are seen.

Clinical

Multiple transverse ridges of the thumbnail are characteristic. The lunula is usually large. The proximal nail fold skin is often thickened, scaly or otherwise abnormal reflecting manipulation of the skin (picking).

RegionalDerm

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