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In the nail bed, hyperpigmentation may also be present.43 These habits predispose to complications such as paronychia, transmission of viral warts, and dental alterations including malposition and fractures, as well as oral infections.43 The differential diagnosis includes onychomycosis, psoriasis, lichen planus, chronic paronychia, and nail-patella syndrome, among others.44 Treatment of OCD can be challenging and should include a multidisciplinary approach

However, most previous studies were conducted in general smoking populations without metabolic comorbidities and relied primarily on behavioral outcomes (14, 15)

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These mechanisms converge during caspase-1 autocatalytic processing, generating functional p20/p10 subunits that increase three-fold relative to the baseline