That could be anybody's fist.

"Hold still, jr. This will only take a minute. It's just a sharpie, and it'll fade away in a couple weeks. You know, if you'd quit snorting, your hands wouldn't shake so much."

Was the "M S 1 3" printed on afterwards, as a designation of the images? They sure don't look like they were made on actual skin.

That definitely looks photoshopped. There's no curvature or anything, and it's too dark & defined. A three-year-old could see that was fake.

Searching, I've seen a whole bunch saying bad photoshop, but I also came across indication that apparently Trump's people added the letters to show what the images indicate... Marijuana for "M"... Smile for "S"... and, um, whatever. Yet MS13 tatts say, "MS13"