Keith Wagner
University of Texas Medical Branch
Introduction: Online skin disease hoaxes have been circulating since 2003, but there has been no previous investigation about how frequently they are viewed by internet users and if viewers think they represent real skin diseases. The purpose of this preliminary study was to determine how widely skin hoax images were seen by internet users, if viewers thought these skin diseases are real, and to identify factors involved in viewer belief that these images represented real skin diseases. Methods: A 10 question, anonymous online survey was administered to a convenience sample of internet users over a three month period to determine if participants had been exposed to five online skin disease hoaxes. The survey was completed by 105 respondents. Reassurance was provided at the end of the survey that none of these images represented real skin diseases. The primary study measures were the percentage of participant recognition of online hoax images and whether viewers believed these images represented real skin diseases. Results: 54.3% of those surveyed had seen one or more of the skin disease hoax images before, with the lotus breast the most frequently seen (41.9%). Forty percent of respondents believed that at least one of the hoax skin disease images were real, regardless of whether they were familiar with the image. Those using the internet less than 4 hours daily (p<0.0219) and older users (p<0.0461) were more likely to believe these hoaxes were real. Participant education did not predict viewer belief that images represented a real skin disease. Conclusion: More than half of the internet users surveyed were familiar with skin disease hoax images. Since exposure to media images of skin disease have been reported to increase the distress of people with skin disease, it is important to determine if dermatology patients have viewed these images, and if so, to reassure them that they are online skin disease hoaxes.