The ESRB has confirmed its ruling is behind Dead Island's censored US cover art.
The ratings body gave a statement to IGN outlining its position.
"The video game industry has set guidelines about the types of content that are appropriate in advertising and marketing materials, which includes game box art. According to those guidelines the depiction in the logo was not compliant.
"We never censor or dictate in any way what type of content can be included within a game. However, a game's marketing materials are seen by an audience that is much broader than that which actually purchases the game itself, so we enforce industry-adopted guidelines as to what is suitable for inclusion in these materials.”
Game Politics turned up the relevant guideline (my emphasis):
“Repeated blows or gun shots inflicted upon people/creatures, violent blows to the head, guns/weapons pointed at head, impaling, exploding body parts, guns/weapons pointed toward reader/audience, depictions of fatal injuries and/or suicide, strangulation/choking, inflicting wounds with swords/knives, kicks to the groin”.
Deep Silver will release Dead Island in other territories with its original box art, depicting a hanged figure, when the game arrives on PC, PlayStation 3 and Xbox 360 later this year. The US version shows an apparently unharmed zombie in its place.