JACKSON'S EXPLANATION FOR SKIN COLOR CHANGE PLAUSIBLE, DOCTORS SAY

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, February 16, 1993                   TAG: 9302160244
SECTION: EXTRA                    PAGE: 3   EDITION: METRO 
SOURCE: BARBARA W. SELVIN NEWSDAY
DATELINE:                                 LENGTH: Medium
JACKSON'S EXPLANATION FOR SKIN COLOR CHANGE PLAUSIBLE, DOCTORS SAY
When pop star Michael Jackson told Oprah Winfrey and a national television audience that a skin disorder, not "skin bleaching," had lightened his complexion in recent years, he seemed near tears.
That explanation is completely plausible, doctors said last week, and Jackson's emotional reaction is typical of those who have vitiligo, the most common illness that strips color from the skin.
"If that's truthful, and it seemed very plausible and sincere to me, I would think he has vitiligo," said Dr. Paul Kechijian, a dermatologist at both New York University Hospital and North Shore University Hospital in Manhasset, N.Y.
Jackson did not name the disease, and there are others that cause white spots on skin. But experts consulted Thursday - none of whom had treated Jackson - said that vitiligo (pronounced vit-ih-LYE-go) is the only one that could cause an allover lightening. Vitiligo kills the cells that produce skin pigment. It usually leaves skin mottled and blotchy. Many cases run in families, although scientists suspect that environmental exposures may trigger them.
The disease strikes 1 percent to 2 percent of all people worldwide, regardless of race or sex, although the darker the natural color of the skin, the more obvious the blotches become. An estimated 2 million to 4.5 million Americans have the disease.
If Jackson does have vitiligo, it could explain some of the entertainer's famous quirks, such as the glove he favors - the blotching often begins on hands and then spreads - and his self-imposed isolation.
"More than two-thirds of patients become almost reclusive," said Allen Locklin, a vitiligo patient who co-founded the National Vitiligo Foundation in Tyler, Texas, in 1985. "If you walk around looking like a painted pony, you get shunned. . . . We get letters all the time from people who say they have attempted suicide. We have to assume some people probably have killed themselves."
Jackson is not the only stricken celebrity. Locklin said that actor Dudley Moore belongs to the foundation, and Moore's spokeswoman confirmed that he has the disease.
If small areas are "depigmented" - that is, the pigment-producing cells, called melanocytes, are destroyed by the disease - patients may try repigmentation. Cortisone creams may suppress the immune response that leads the body to kill its melanocytes, permitting unaffected cells to migrate to the whitened areas, said Dr. Steven Cohen, director of dermatology at Beth Israel Medical Center in New York City. Grafts of skin containing melanocytes are another option.
Another treatment combines cortisone creams with psoralen, a drug taken orally, and thrice-weekly exposure to ultraviolet light. This therapy requires 200 to 400 ultraviolet exposures and cannot guarantee complete repigmentation, said Dr. Marcia Tonnesen, a dermatology professor at the State University of New York's Stony Brook medical school.
It works in only 15 percent to 20 percent of cases, said Dr. Alan Lerner, a professor emeritus of dermatology at Yale University who is considered the world's leading vitiligo expert.
People who have lost pigment in more than 50 percent of the skin on their face or hands - places difficult to cover with clothing - sometimes opt for depigmenting the rest of their skin with a strong prescription cream that kills all remaining melanocytes, producing an even, pale tone. This treatment is irreversible, but recipients "are very happy," Lerner said.
"I assume, without knowing any of the details, that that's what happened to Michael Jackson," Lerner added. In the interview broadcast last Wednesday night, Jackson denied that he had bleached his skin. Lerner said it was possible that Jackson did not consider the medical depigmentation "bleaching" per se.
Jackson told Winfrey that his father said the disease ran in the family.

by Archana Subramaniam by CNB