Nail picking disorder (onychotillomania): A case report

• We report a case of a male client with a clinically significant nail picking habit.
• Characteristics of the nail picking resembled hair pulling and skin picking disorders.
• The client responded moderately well to acceptance-enhanced behavior therapy.

Nail picking disorder (onychotillomania) is characterized by excessive picking or pulling at one's own finger- or toenails. This condition has received scant research attention and may be related to other body focused repetitive behaviors such as pathological nail biting, skin picking and hair pulling. We present a case of a male client with a chronic and severe nail picking habit treated with acceptance-enhanced behavior therapy. The client showed clinical characteristics similar to other body focused repetitive behaviors and responded moderately well to the treatment.