What are common dermatologic features of classic movie villains?

Dermatologic features are used in movies to contrast good and evil in heroes and villains. So what features are common?

In a new article published by JAMA Dermatology, Julia A. Croley, M.D., of the University of Texas Medical Branch, Galveston, and colleagues used the all-time top 10 film heroes and villains from the American Film Institute (AFI) 100 Greatest Heroes and Villains List. For each of the 20 characters on the AFI list, dermatologic characteristics were evaluated from color film or colorized versions of original black-and-white film. The color theatrical release poster was used if no colorized movie version was available.

The authors identified and compared dermatologic findings for famous film heroes and villains, including Dr. Hannibal Lecter ("The Silence of the Lambs," 1991), Mr. Potter ("It's a Wonderful Life," 1947), Darth Vader ("The Empire Strikes Back," 1980), The Queen ("Snow White and the Seven Dwarfs, 1938), Regan MacNeil ("The Exorcist," 1973) and The Wicked Witch of the West ("The Wizard of Oz," 1939).

Six of the top 10 villains - 60 percent - have dermatologic findings that include:

• Alopecia (hair loss, 30 percent; Dr. Lecter, Darth Vader and Mr. Potter)
• Periorbital hyperpigmentation (dark circles under the eyes, 30 percent; Darth Vader, Regan MacNeil and The Queen)
• Deep rhytides on the face (wrinkles, 20 percent; Darth Vader and The Queen)
• Multiple facial scars (20 percent; Darth Vader and Regan MacNeil)
• Verruca vulgaris on the face (warts, 20 percent; The Wicked Witch of the West and The Queen)
• Rhinophyma (bulbous nose, 10 percent; The Queen)

While six film villains had dermatologic findings on their face, only two film heroes did: Harrison Ford as Indiana Jones in "Raiders of the Lost Ark" (1981) and Humphrey Bogart as Rick Blaine in "Casablanca" (1943) had facial scars. However, the authors note facial scars of heroes are usually more subtle and shorter than those of villains.

"The results of this study demonstrate Hollywood's tendency to depict skin disease in an evil context, the implications of which extend beyond the theater. Specifically, unfairly targeting dermatologic minorities may contribute to a tendency toward prejudice in our culture and facilitate misunderstanding of particular disease entities among the general public. In some cases, filmmakers are tasked with addressing biased portrayals of dermatologic disease, as evidenced by the goals of advocacy groups," the article concludes.