This patient has a habit-tic deformity, a relatively common nail disorder that is often confused with onychomycosis. It is caused by the conscious or unconscious rubbing and picking of the proximal nail fold and cuticle area. Habit-tic deformity is most often found on the thumb of the dominant hand, which is being rubbed by the index or middle finger of that same hand.

While habit-tic deformity is considered to be a compulsive disorder, and medications such as selective serotonin reuptake inhibitors have some theoretic use, a much simpler approach with fewer side effects may be even more effective. The patient could apply tape over the mid-nail fold and cuticle area during waking hours. The tape serves as a constant reminder to the patient and an interruption to the habitual trauma. There is nothing that can be done to "repair" the already damaged nail plate, but the patient will see results in two to three weeks as the nail matrix quickly recovers and produces a normal nail.