Shiels said cases in five other cities in Ohio and several reports in Naperville, Ill., popped up once he and his colleagues announced the self-embedding disorder. "What happens, we believe, is that people are just discarding it as a fluke case," he said.
Veteran psychiatrists disagree about why self-embedding stayed underneath the radar of so many other medical professions.
Lader suggested embedding may only be one small part of a growing problem of self-injury that has been gaining attention.
"Self-injury in general has definitely increased over the years, and probably in the last five or 10 years it has gone exponential," Lader said. "We just finished a school manual [for teacher awareness] and we haven't even fully advertised it yet, but people are clamoring for it."
Other experts in self-injury and adolescents say that embedding may not turn out to be a lasting trend, but rather one example of how self-destructive behavior moves in fads.
"Embedding things or putting things in one's body has been a pretty old-fashioned part of self-mutilation," said Dr. Alexander Obolsky, a distinguished fellow of the American Psychiatric Association and an assistant professor of clinical psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine in Evanston, Ill.
"It doesn't strike me as a particularly new thing," said Obolsky, who has seen young adults embed objects in their genitals or under their skin in his private practice in Chicago.
Nadine Kaslow, professor and chief psychologist at the Emory School Medicine/Grady Hospital in Atlanta, has certainly seen self-embedding, even a generation ago.
"This has been around for a long time. I remember patients doing this in the '80s," said Kaslow.
"These things kind of goes in waves," she said. "There was a wave of anorexia, there was a wave of bulimia. … This may be one of the current trends in self-mutilation."
Despite doing in-depth interviews with the 10 patients at his hospital, Shiels said he still could not pinpoint how the idea of self-embedding passed from teen to teen.
"Two of them may have spoken with each other because they were in the same group home," said Shiels. However the other adolescents had no contact with each other, and according to Shiels, all the patients say they did not find the information on the Internet.
According to Kaslow, it's not necessary for a Web site or a group to directly spread a trend; it just takes some talk of an idea to spread around.
"It's sort of a contagion factor, kids hear about it, it's a new idea. … Then there's a subgroup who finds it appealing," she said. "Recently it was the choking game."
While the majority of adolescents may just spread the idea and never self-injure, Kaslow said some susceptible proportion of people who hear the idea will try it.
Dr. Armando Favazza, author of the book "Bodies Under Siege" and a professor of psychiatry at the University of Missouri-Columbia, has found evidence of a spontaneous self-embedding trend in early 19th century Europe.
"Back in 1896 psychiatrists compiled medical reports on women [they labeled them all as hysterical] who stuck pins in their bodies," said Favazza.
Just like Shiels presented Dec. 3, doctors in the 1890s presented X rays of women with needles, sometimes hundreds, embedded in their skin.