I use tattoo for lack of a better word, but yes, it's almost certainly due to the orb in Gale's chest.
I'm surprised I'm the only one who finds the look similar to Shar's symbol.
Wasn't the orb Netherese in nature? Shadow magic? Isn't that naturally connected to Shar?
What are the chances that Gale has ***TWO*** things inside of him that basically Netherese? One, an orb, and two, a tadpole?