{"title":"What Is the Diagnosis? Onycho-Trichotillomania: An Unusual Case Report","authors":"Giulia Merlo, Mirko Benvenuti, Gabriele Zanardi, Emanuele Claudio Cozzani","doi":"10.1016/j.nurpra.2025.105554","DOIUrl":null,"url":null,"abstract":"<div><div>Nail discoloration is commonly attributed to fungal or bacterial infections, trauma, or inflammatory nail disorders. In rarer cases, however, chromatic alterations may result from compulsive or repetitive behaviors—subtle signs often overlooked during the initial assessment. This case highlights the importance of a comprehensive diagnostic approach: clinical examination and laboratory testing ruled out typical causes, whereas dermoscopy and microscopic analysis, combined with detailed behavioral evaluation, uncovered an unexpected psychodermatologic etiology. The case underscores the need for diagnostic openness and sensitivity to behavioral cues, reminding clinicians that careful observation can reveal hidden causes behind seemingly common dermatologic presentations.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"21 10","pages":"Article 105554"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal for Nurse Practitioners","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1555415525002375","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Nail discoloration is commonly attributed to fungal or bacterial infections, trauma, or inflammatory nail disorders. In rarer cases, however, chromatic alterations may result from compulsive or repetitive behaviors—subtle signs often overlooked during the initial assessment. This case highlights the importance of a comprehensive diagnostic approach: clinical examination and laboratory testing ruled out typical causes, whereas dermoscopy and microscopic analysis, combined with detailed behavioral evaluation, uncovered an unexpected psychodermatologic etiology. The case underscores the need for diagnostic openness and sensitivity to behavioral cues, reminding clinicians that careful observation can reveal hidden causes behind seemingly common dermatologic presentations.
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