Can urticaria images found on the internet be a source of health information?

In parallel with technological developments, patients increasingly benefit from information and communication technologies.

The aim was to evaluate urticaria images that are available on the internet in two different languages.

The terms "urticaria" and "ürtiker" were used as search terms on Google Images. One hundred images were saved for each term, and each image was opened via its link. Two specialists in immunology and allergy jointly assessed the uploader information, pixel resolution, characteristics of the urticarial lesions, and image quality of the photos.

A total of 178 images were included, with 87 from the "urticaria" search term and 91 from the "ürtiker" search term-71.3% images had isolated urticaria, 1.7% had isolated angioedema, 0.6% had both urticaria and angioedema, and 26.4% had neither urticaria nor angioedema; 131 photographs depicting urticaria and/or angioedema were analyzed. The majority of urticarial plaques were erythematous (84%), with extremities (32.1%) being the most commonly affected area. Images in the preview on Google Images appeared more blurred and of lower resolution than the images after opening the link (n:99 vs. n:26, p < 0.001 and n:55 vs. n:10, p < 0.001, respectively). The quality of the images was found to be better after opening the link compared to the preview (n:34 vs. n:107; p < 0.001).

Our study found that approximately one-quarter of urticaria images on Google Images did not match true urticarial lesions and were of suboptimal quality in both Turkish and universally accessible English.