Hoaxes are nothing new to medicine, with medical hoaxes reported as early as 1593. Recently, the internet and improved photo editing tools have created an opportunity for hoaxers to reach massive audiences through a visual medium. For more than a decade, skin disease has been a frequent target of these kind of hoaxes; however, until recently, they were not described in the academic literature. These hoaxes often take advantage of trypophobia (the fear of clustered holes) or acarophobia (the fear of insects in the skin). Research has indicated that trypophobic patterns are especially disturbing to individuals with skin disease and may cause exacerbations. A 10 question convenience survey was launched online to evaluate the scope and potential impact of 5 online skin disease hoaxes (lotus breast, lamprey fingers, trypophobia foot, blue waffle hand, and ham face girl). 71 survey responses from North America, South America, Europe, Australia, and Asia reported seeing the images most frequently on image boards, forums, and social media. 58% of respondents had seen at least one of the hoax images before taking the survey and only 56% of respondents were able to correctly identify that all of the images in the survey were not real medical conditions. It is concerning that more than half of respondents had seen these images before, and 44% of respondents thought that at least one of the images represented an actual skin disease. More research about the impact of skin hoax images on internet viewers and how they may influence perceptions and behaviors regarding skin diseases is needed.
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