She wears the aristocratic horned headdress (escoffion) of her youth, out of fashion by the time of the painting, and holds in her right hand a red flower, then a symbol of engagement, indicating that she is trying to attract a suitor.
[2] The painting was long thought to have been derived from a putative lost work by Leonardo da Vinci, on the basis of its striking resemblance to two caricature drawings of heads commonly attributed to the Italian artist.
[3] A possible literary influence is Erasmus's essay In Praise of Folly (1511), which satirizes women who "still play the coquette", "cannot tear themselves away from their mirrors" and "do not hesitate to exhibit their repulsive withered breasts".
[2] The woman has been often identified as Margaret, Countess of Tyrol, claimed by her enemies to be ugly;[4] however, she had died 150 years earlier.
[5] A 1989 article published in the British Medical Journal speculated that the subject might have suffered from Paget's disease,[6] in which the victim's bones enlarge and become deformed.
Her dress, with tightly laced corseted front, pushes her wrinkled breasts up beyond propriety standards for the period.
[7] With her ugly features and advanced age, this red flower only adds to the satirical nature of Matsys's work.
[9] Matsys achieved the uneven appearance of her flesh by layering the basic pink with red and white dots in sporadic dashes and blotches.
He then decreased the final appearance of the chin, neck and right ear, visible by comparing the paint to the under drawing.
Externally, based on her exquisite dress, jeweled accessories, and budding flower, this woman was theoretically beautiful.
[11] Refer also to Erasmus's essay In Praise of Folly (1511), which satirizes women who "still play the coquette", "cannot tear themselves away from their mirrors" and "do not hesitate to exhibit their repulsive withered breasts".
[12][13] With the completion date estimated to be 1513 for The Ugly Duchess it is highly likely that Erasmus's essay influenced Matsys's production.
A 1989 article published in the British Medical Journal and emeritus professor of surgery at University College London, Michael Baum also offer speculation on the Duchess's diagnosis with Paget's.
[15] While much of the discussion concerning Paget's disease focuses on the physical representation of the condition, scholar Sarah Newman suggests that the portrait also provides cultural insight into how disability was viewed in the sixteenth century.
Historian Gretchen E. Henderson's book Ugliness: A Cultural History follows a similar line of discussion, but focuses on the interpretation of disability in artwork.
[17] As a sufferer of Paget's disease, the woman no longer appears the fool holding a red blossom that will never bloom, but a victim of unfortunate circumstances.
However, when considering the under drawing and primary sketches beneath the paint, scholars now believe that Matsys had created the Duchess long before the portrait's completion.
The now popular theory is that Matsys sent da Vinci an early sketch that then inspired the Italian artist to copy the exaggerated form of the woman's grotesque features.
Tenniel's Duchess has a lower headdress, and the large ears, leathery neck and breasts prominent in the original portrait, are concealed.