Warts and all: Derm pub retracts plantar paper after author cries foul

Both Retraction Watch bloggers are all too familiar with the artwork in dermatology journals. One of us, AM, used to write for Skin & Aging, while the other, IO, waited eagerly for issues of Cutis sent to his pediatrician father to show up on the coffee table. And IO recently broke the incredibly important story of “Mexican beer dermatitis.”

But we always trusted that the images we were looking at were real. A group of Egyptian dermatologists seems to have hit on a novel solution to the problem of uncooperative images: Fabrication.

The Journal of the American Academy of Dermatology has retracted a paper it published earlier this year online by authors from Zagazig, a town on the Nile whose favorite son (according to Wikipedia) appears to be PlayStation hero Sherif Talaat Khalil.

The researchers claimed to show that it’s possible to eliminate plantar warts—those pesky bumps that appear on the feet and which are caused by infection with human papillomavirus—by injecting them with the combination vaccine against measles, mumps and rubella to stimulate the body’s immune system. (MMR, you’ll recall, was involved earlier this year in what might be the most sensational retraction ever of a 1998 Lancet study that alleged, falsely, it happens, that the shot was linked to autism.)

According to the Egyptian researchers, the MMR therapy “completely” cleared plantar warts in 20 of 23 patients (nearly 90%), and partially removed them in one more patient. Helpfully, the journal abstract provides a section on limitations, which lists the small size of the study and the lack of a control group.

To which we might add the following: Lack of believability.

Per the editors:

This article has been retracted because Figure 1C appears to be a digitally altered version of Figure 1B. In addition, the lead author asserts that the signature on the submission form for the manuscript is  not hers. The lead author also asserts that the published figures were not part of the investigation that is the subject of the report.

Indeed, the last two images—a rather plump left foot lying against some kind of floral-print backdrop—appear to be identical with the exception of the missing lesions in the final shot. The placement of the foot against the details of the pattern is so close that it seems highly unlikely to have occurred twice by chance.

Bruce Thiers, editor of the journal, said he learned of the issues with the article from a reader who contacted him after seeing the online version.

As for the substance of the study, Thiers said:

Dr. Gamil [the lead author] claims the study is valid but the figures in question were from a patient who was not part of the study. Plantar warts are inherently difficult to treat, so if this treatment is effective it would be a significant advance.

We’ve tried to reach Gamil, but haven’t yet managed to contact her. We’d love to ask her how her name came to be on the paper when she didn’t put it there. We’d also like to know how she can be convinced of the validity of the findings when not only was her name forged but an image manipulated—and the image came from a patient who she maintains was not in the study.