No it’s an actual tat–you can see the equipment in the background and the ink on his toes where it gets wiped. The real concern is the inevitable infection that he loses his toes to seeing how sloppily he cares for those gnarly looking things.
It is not photoshopped, I can tell. I work w/photoshop and know the signs to look for. However, I kind of do think it’s faked with ballpoint pen though. It looks like the subject is displaying his nasty foot as if it was a freshly-inked tattoo with the background of equipment to help make it look authentic. But if it was newly inked, wouldn’t the skin be red, a little swollen, an have that shine of protective lotion or w/e that is on it?
I’m not a tattoo expert, but I am a photoshop expert. And the verdict on this one is… 100% GROSS.