According to the grand jury depositions in 1994 Michael was diagnosed with discoid lupus in 1986.
Vitiligo and lupus are both auto immune disorders; diseases where the body’s immune system attacks its own cells. When you have one auto immune disorder your propensity for having another is increased and it seems as though Michael first developed vitiligo as a child and then the first signs that he also had lupus were at the age of 18 when he suffered a pneumothorax related to pleurisy, followed by the appearance of the discoid lupus rash at the age of 24.
He presented with one of the trademark symptoms of the illness, the Malar or Butterfly Rash in 1983 and 1984, which reappeared again in 1986.
Michael in 1983 and 1984
And in 1986 when he was diagnosed with the disease.
In 1990 and 1991 Michael was seen wearing a small plaster on his face just to the right of his nose
In this photo of Michael on the set of Black or White in 1991 he isn’t wearing any make up and you can see a faded blemish right in the area where that plaster had covered
He was also seen with blemishes on other occasions; on the left in the late 90s and on the right a photo taken around 2002
These marks are consistent with lupus lesions, another symptomatic form of discoid lupus:
The lesions normally are inflamed, crusty or scaling in its appearance, with the lighter complexion at the center and rims being darker.
This is what Michael has said about his sun sensitivity:
Question: Why are you wearing a silk mask in your latest appearances?
Michael: Because… uh… with time my skin condition has gotten worse. I hate to say it. I have vitiligo and uh, I am totally completely allergic to the sun. I’m not even suppose to be outside actually, even if I am in the shade the sunrays can destroy my skin.
He is famous for having been seen carrying an umbrella:
1986 is when Michael was diagnosed with lupus and this is also when he first started wearing the surgical mask to cover his face. The late 80s is also when he first started carrying around umbrellas. This is because lupus is aggravated by sun exposure.
- Photosensitivity is a common feature of lupus erythematosus.
- The overwhelming majority of specific lupus lesions, occur on sun-exposed areas.
- In people with cutaneous lupus, photosensitivity affects 50 percent of those with discoid lupus and 70-90 percent of those with subacute cutaneous lupus.
- Furthermore, people with subacute cutaneous lupus erythematosus, especially those who have anti-Ro (SSA) antibodies demonstrate pronounced photosensitivity.
- It has been estimated that 90% of patients with systemic or discoid lupus who have anti-Ro (SSA) antibodies are photosensitive.
- Furthermore, a number of these patients are so photosensitive that they will burn through window glass.
- Also there is clinical evidence that shows that ultraviolet light can induce flares in people with sle.
Once he’d started covering his face up it seems to have halted further appearances of his malar rash.
His first malar rash appeared in 1983 which is also when he had his second nose job. Dr Richard Strick was one of the doctors appointed by the District Attorney to perform the court ordered examination of Michael in December 1993 and had reviewed Michael’s medical records, he has stated that the reasons Michael had so many nose jobs were for “reconstructive” reasons due to the skin healing problems and scarring associated with his discoid lupus.
“Lupus is also an autoimmune disease and he also had skin involvement, which had destroyed part of the skin of his nose and his nasal surgeries and all were really reconstructive, to try and look normal. “
So all these nose reconstructions you’re saying were as a result of him treating his lupus?
“The first one was to try and reconstruct from some scar tissue and obstruction that had happened with the skin there. It didn’t work out very well and all subsequent attempts were to make it right.
I think he was trying to look like a normal guy as best as that he could.”
According to Dr Brooke Seckel:
Lupus can cause large areas of skin on the face or tummy to actually die after plastic surgery and result in terrible scars.
The fact that his second nose job occurred during a discoid lupus flare up likely complicated the healing there and this is why he needed reconstructive work done.
Regarding the state of his lungs (the “blisters” Michael would tell Quincy Jones about), this was the pleurisy that he’d been diagnosed with in 1977 – pleurisy is autoimmune in nature and directly associated with lupus.
Cardiopulmonary complications from SLE, those affecting the lungs specifically, are common in lupus patients. Often, lupus can trigger inflammation of the lining surrounding the lungs, the pleura, causing pain when breathing or coughing. This condition is called pleurisy or pleuritis. It is the most common pulmonary manifestation of lupus.
Pleurisy’s main symptom, however, is pain in the chest and, possibly, the shoulder, worsened by deep breathing, coughing, and movement of the chest. It can also cause a build up of fluid in the chest, making breathing difficult and causing coughing, cyanosis (blueness of the skin from oxygen deprivation; occurring in only the most extreme cases of pleural fluid accumulation due to lupus pleuritis), shortness of breath and rapid breathing.
The issue with his lungs seems to have begun at the age of 18 after Michael suffered a pneumothorax in 1977.
Michael Jackson is feeling his old energetic self again after suffering a lung collapse recently that forced a month’s cancellation of The Jackson family concerts. Explaining his son’s uncomfortable condition, Joseph W. Jackson, president of Ivory Tower Records, explained to Jet, “Michael’s lung collapse came as a result of overwork from the family’s television series and other projects. Essentially what happened is that over a period of time a bubble appears on the lung and eventually bursts. Each time it does, a fraction of the lung is destroyed. People don’t realize how the grind of television can affect you, even during just a 30- minute show.”
Restricted to total rest for a month, Michael bounced back on his feet to begin filming his role as the Scarecrow in the upcoming movie version of The Wiz in New York City.
Said his father, “He’s feeling all right now. If he weren’t I certainly wouldn’t have let him go to New York.”
Michael stated that the issues with his lungs involved pleurisy in “The Wiz,” by Mark Bego published in 1983
However, before principal filming began, Michael had a real physical health scare. As he tells it, “I had a lung attack on the beach on the Fourth of July. I couldn’t breathe. They had to rush me to the emergency hospital. The doctor said it was pneumothorax; bubbles on the lungs, and the bubbles burst and you can’t breathe. Mostly slim people have it, the doctor said. He said there was a little bit of pleurisy there too. It reminded me that Buddy Ebsen was supposed to be the Tin Man in the original Wizard of Oz and he broke down sick before the thing.”
And then again in his Moonwalk autobiography in 1988
“The whole Wiz period was a time of stress and anxiety, even though I was enjoying myself. I remember July 4 of that year well, because I was on the beach at my brother Jermaine’s house, about half a block away along the waterfront. I was messing around in the surf, and all of a sudden I couldn’t breathe. No air. Nothing. I asked myself what’s wrong? I tried not to panic, but I ran back to the house to find Jermaine, who took me to the hospital. It was wild. A blood vessel had burst in my lung. It has never reoccurred, although I used to feel little pinches and jerks in there that were probably my imagination. I later learnt that this condition was related to pleurisy. It was suggested by my doctor that I try to take things a little slower, but my schedule would not permit it. Hard work continued to be the name of the game.”
His autopsy report confirmed the problems with his lungs, which were reported as being chronically inflamed with a reduced capacity:
- Marked respiratory bronchiolitis, histiocytic desquamation, and multifocal chronic interstitial pneumonitis, and
- Suggestive focal desquamation of respiratory lining with squamous metaplasia
In Dr Conrad Murray’s medical notes for Michael entered into his 2011 trial he makes note of the pleurisy and says that MJ was coughing up blood in March 2007:
3/07 (not day given):
“M” — cough, chills, (cut off)
with intermittent specs of blood (cut off)
Phlegm greenish brown
Pleuritic chest pain with cough (cut off)
lower rib cage
chest x-ray positive for right lower lobe pneumonia
One of his long time physicians was a Dr Allan Metzger, a lupus specialist rheumatologist. He treated Michael during his stay in 1995 and even treated Prince during an illness he suffered from in 1999. They were so close that Metzger was the one who videotaped Michael and Debbie’s wedding and was godfather to one of Michael’s kids. On October 1st 2003 they both attended and gave a brief speech together at an Evening of Love, Light and Laughter, a benefit for Lupus LA and Lupus Research at the Beverly Hills Hotel in Beverly Hills, California.
People have questioned why his diagnosis for Lupus never came out in his autopsy – unfortunately that’s the nature of the disease. It seems an ANA test wasn’t performed (according to the results available online), but even so, people with lupus don’t always test positive, numerous tests are involved in the diagnosis of this disorder. Those who suffer mainly from discoid lupus also tend not to test positive in an ANA test. Though in that report there are a couple of interesting things noted – the alopecia, he was anemic, the hemorrhages found in his lungs are consistent with the pleurisy and the prescription he had for Prednisone.
Michael Jackson biographer J. Randy Taraborrelli claims the performer wanted to talk more about the color of his skin during his “PrimeTime Live” interview with Diane Sawyer.
The writer says Jackson told him he now has discoid lupus, a nonfatal form of the disease, which requires him to take a medication called hydroxychloroquine. And, according to Jackson, the drug causes vitiligo loss of pigmentation.
N.Y. skin expert Dr. Howard Sobel tells us, “It is possible for chloroquine to cause hypopigmentation, but whether it’s the cause of his problem is hard to tell you. The chloroquine binds to melanin, which is responsible for the pigment of our skin. If that happens, it’s possible to have a whitish area of skin.”
On wikipedia it states the use of Hydroxychloroquine with lupus:
The adult starting dose is 400 milligrams one to two times daily, for several weeks or months, depending on the reaction. This may be reduced to 200 from 400 milligrams per day for maintenance. With systemic lupus, it is especially useful in relieving skin inflammation, hair loss, oral sores, fatigue and joint pain as well as preventing relapse.
Which is consistent with the symptoms of lupus Michael was trying to treat.
In his autopsy report it was stated that they found the drug Prednisone in his house.
Prescribed: 4/25/2009, Dr Klein
No. of pills: 10
Pills remaining: 0
Directions: 6 now, 4 tomorrow
Prednisone is one of the most common drugs used in the treatment of lupus. Lupus Canada says of the drug:
In the chapter Treating Lupus With Medications, I talked about Prednisone as being the single most important factor in improving the outlook for lupus patients. It is a very powerful tool in the treatment of lupus, it is usually effective in bringing lupus under control and it saves lives.
Prednisone has side effects, some of which are:
Swelling of the face, often referred to as “moon face” or “chipmunk cheeks”; some patients feel ugly and say that they do not recognize themselves in the mirror. Remember, these changes are reversible.
Weight gain; Prednisone may cause a great increase in appetite. Weight gain can be controlled by a low calorie diet, by exercise and by avoidance of salt. Avoid salty foods and do not add any salt.
Michael also spoke of having changed to a vegetarian diet in the early 80s, this might have also been due to his lupus. Michael’s doctors have said that he had been diagnosed with lupus in 1986, this is a photo of Michael in 1986:
His face became noticeably puffy and he looks like he has the so-called “moon face“, which seems in line with the idea of his being treated for the disease with the steroid Prednisone. He was also said to have had a lupus flare up in 2002 and once again in a photo in 2002 his cheeks are puffy and his face has the same appearance as it did in 1986.
Other side effects:
Stomach problems; to ease the burning, try taking prednisone with food. This problem may require anti-ulcer medication.
Mood changes; sometimes the change is for the better. However, depression may be made worse by prednisone.
Insomnia; patients may have difficulty sleeping at nights.
Shakiness; patients may have feelings of being “hyper: or that “things are running fast inside my head”.
Weakness of the thigh muscles; patients may have difficulty in climbing stairs, getting out of the bath or getting up from a chair or toilet seat.
Increased risk of infections; patients may have more infections including some caused by germs that the body is normally resistant to.
In 2002 Michael filmed the 8 month documentary “Living With Michael Jackson” with Bashir; his ex-wife Lisa Marie has since said that watching that footage, “He was either too speedy or he was sedated. It wasn’t the Michael that I knew,” this could have been due to the Prednisone.
This drug was prescribed two months before his death and he had taken all the prescribed dosage; this is also the same period in time where it seems Dr Conrad Murray first began using propofol to induce sleep in Michael. As you can see one of the side effects of Prednisone is insomnia, so part of the problem with his sleep may have involved the use of this drug. His battle with insomnia is something that he seems to have been suffering with for many years, both his wives Lisa Marie and Debbie Rowe have spoken about it.
Lisa was dating him on and off through 1993-2000, in her Oprah interview in 2010 she said:
Oprah: Was he having trouble sleeping then?
Lisa: He was like a little gnome. I used to tell him he was a gnome running around the room because it was hard for him to sleep. A lot of times I couldn’t sleep either if he wasn’t sleeping. I’d just hear him piddling. It was a bit endearing but then I didn’t mind it. But he did have a hard time sleeping, yes.
And Debbie Rowe who married him from 1996-1999 said back in a Star magazine scoop (she didn’t realize she was being recorded) in 1997:
Debbie: He’ll stay up until 4 am pacing, thinking. Sometimes he’ll come up to me in the middle of the night when I’m asleep and stick things in my nose or my ear and wake me up. Sometimes I wake up and I won’t hear him and I’ll be in a panic. When I realize he’s asleep, I go into his room and climb into bed with him because than we can sleep together.”