Vitiligo
Classification and external resources
Non-segmental vitiligo of the hand.
ICD-10	L80
ICD-9	709.01
OMIM	193200
DiseasesDB	13965
MedlinePlus	000831
eMedicine	derm/453
MeSH	D014820

Vitiligo ( /ˌvɪtɨˈlaɪɡoʊ/) is a condition that causes depigmentation of sections of skin. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function. The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic, oxidative stress, neural, or viral causes.^[1] The incidence worldwide is less than 1%.^[2] The most common form is non-segmental vitiligo, which tends to appear in symmetric patches, sometimes over large areas of the body.

Signs and symptoms[link]

The most notable symptom of vitiligo is depigmentation of patches of skin that occurs on the extremities.^[3][4] Although patches are initially small, they often enlarge and change shape.^[1][3] When skin lesions occur, they are most prominent on the face, hands and wrists.^[3][4] Depigmentation is particularly noticeable around body orifices, such as the mouth, eyes, nostrils, genitalia and umbilicus.^[3][4] Some lesions have hyperpigmentation around the edges.^[5] Patients who are stigmatised for their condition may experience depression and similar mood disorders.^[6]

Treatment[link]

There are a number of treatments for vitiligo. Treatment options generally fall into four groups:^[7]

UVB phototherapy[link]

Exposing the skin to UVB light from UVB lamps is the most common treatment for vitiligo. The treatments can be done at home with a domestic UVB lamp or in a clinic. Normally a small lamp is needed if the spot is small. Treatment can take a few weeks if the spots are on the neck and face and if they existed not more than 3 years. If the spots are on the hands and legs and have been there more than 3 years, it can take a few months. In a clinic the treatments are done 2-3 times a week, and at home every day, which makes the home treatments more effective. If the spots are on a large area of the body, full body treatment in a clinic or hospital will be needed. Both UVB broadband and UVB narrowband lamps can be used.^[8][9] However these treatments are unreliable at best.^{[citation needed]} There is no treatment that totally repigments the skin. Adding a psoralen, a photosensitizer that increases the effect of the UV light, can aid in partial repigmentation.

Studies have shown that immunomodulator creams such as Protopic and Elidel also cause repigmentation in some cases, when used with UVB narrowband treatments.^[10][11] A 1997 report suggests that combining vitamin B₁₂ and folic acid supplements with sun exposure caused repigmentation in 52% of cases.^[12]

PUVA phototherapy[link]

Ultraviolet light (UVA) treatments are normally carried out in a hospital clinic. Psoralen and ultraviolet A light (PUVA) treatment involves taking a drug which increases the skin's sensitivity to ultraviolet light. The skin is then exposed to high doses of ultraviolet A light. Treatment is required twice a week for 6–12 months or longer. Because of the high doses of UVA and psoralen, PUVA may cause side effects such as sunburn-type reactions or skin freckling.^[7]

Narrowband ultraviolet B (UVB) phototherapy is now used more commonly than PUVA as it is less damaging to the skin. As with PUVA, treatment is carried out twice weekly in a clinic or every day at home, and there is no need to use psoralen.^[7]

Transplanting melanocytes[link]

In October 1992, a scientific report was published of successfully transplanting melanocytes to vitiligo affected areas, effectively repigmenting the region.^[13] The procedure involved taking a thin layer of pigmented skin from the patient's gluteal region. Melanocytes were then separated out to a cellular suspension that was expanded in culture. The area to be treated was then denuded with a dermabrader and the melanocytes graft applied. Between 70 and 85 percent of patients experienced nearly complete repigmentation of their skin. The longevity of the repigmentation differed from person to person.^[14]

Skin camouflage[link]

In mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale-skinned, the patches can be made less visible by avoiding both sunlight and the tanning of unaffected skin.^[15]

Reversal[link]

The traditional treatment is the application of corticosteroid cream. ^[16]

De-pigmenting[link]

In cases of extensive vitiligo the option to de-pigment the unaffected skin with topical drugs like monobenzone, mequinol or hydroquinone may be considered to render the skin an even colour. The removal of all the skin pigment with monobenzone is permanent and vigorous. Sun-safety must be adhered to for life to avoid severe sun burn and melanomas. Depigmentation takes about a year to complete.^[7]

Non-segmental[link]

In non-segmental vitiligo (NSV), there is usually some form of symmetry in the location of the patches of depigmentation. New patches also appear over time and can be generalized over large portions of the body or localized to a particular area. Vitiligo where little pigmented skin remains is referred to as vitiligo universalis. NSV can come about at any age, unlike segmental vitiligo, which is far more prevalent in teenage years.^[5]

Classes of non-segmental vitiligo include:

• Generalized Vitiligo: the most common pattern, wide and randomly distributed areas of depigmentation^[15]
• Universal Vitiligo: depigmentation encompasses most of the body^[15]
• Focal Vitiligo: one or a few scattered macules in one area, most common in children^[15]
• Acrofacial Vitiligo: fingers and periorificial areas^[15]
• Mucosal Vitiligo: depigmentation of only the mucous membranes^[15]

Segmental[link]

Segmental vitiligo (SV) differs in appearance, etiology and prevalence from associated illnesses. Its treatment is different from that of NSV. It tends to affect areas of skin that are associated with dorsal roots from the spine and is most often unilateral. It spreads much more rapidly than NSV and, without treatment, it is much more stable/ static in course and it is associated with auto-immune diseases and a very treatable condition that responds to topical treatment.^[5]

• 

  Vitiligo on lighter skin

• 

  Vitiligo on darker skin

Differential diagnosis[link]

Conditions with similar symptoms include:

• Pityriasis alba
• Tuberceloid Leprosy
• Postinflammatory hypopigmentation
• Tinea versicolor^[15]
• Albinism
• piebaldism^[15]
• idiopathic guttate hypomelanosis^[15]
• progressive macular hypomelanosis^[15]
• Primary Adrenal Insufficiency

Pathogenesis[link]

Vitiligo is a disorder characterized by patchy loss of skin pigmentation due to immune attacks on melanocytes. Although there is no significant proof or evidence, many doctors believe that it can be caused by defects in many genes. Variations in genes that are part of the immune system or part of melanocytes have both been associated with vitiligo. The immune system genes are associated with other autoimmune disorders.

In one case, the gene TYR, which makes the melanocyte more susceptible to the immune system in vitiligo, also makes the melanocyte more susceptible to the immune system in the skin cancer malignant melanoma. So people with vitiligo caused by the TYR gene are less likely to have malignant melanoma.

A genomewide association study found 10 independent susceptibility loci for generalized vitiligo, responsible for 7.4% of the genetic risk. Some patients had vitiligo alone; others had generalized vitiligo with other autoimmune diseases. Most loci were associated with both forms. (The exception was PTPN22, which was only associated with generalized vitiligo.) In the MHC region, which controls the immune system, major association signals were identified in the class I gene region (between HLA-A and HLA-HGC9) and class II gene region (between HLA-DRB1 and HLA-DQA1). Outside the MHC region, association signals were identified near RERE, PTPN22, LPP, IL2RA, GZMB, UBASH3A and C1QTNF6 genes, which are associated with other autoimmune diseases. TYR encodes tyrosinase, which is not a component of the immune system, but is an enzyme of the melanocyte that catalyzes melanin biosynthesis, and a major autoantigen in generalized vitiligo. The major alleles of TYR are associated with vitiligo, and the minor alleles are associated with malignant melanoma. Vitiligo-associated 402R tyrosinase may be more efficiently presented to the immune system. Melanoma-associated 402Q may fail to be identified by the immune system.^[17]

The transcriptional profile of melanocytes from vitiligo patients have been studied. Oligonucleotide microarrays containing approximately 16,000 unique genes were used to analyse mRNA expression in melanocytes from vitiligo patients and age-matched healthy controls. In total, 859 genes were identified as differentially expressed.^[18]

Vitiligo is sometimes associated with autoimmune and inflammatory diseases,^[19] commonly thyroid overexpression and underexpression. A study comparing 656 people with and without vitiligo in 114 families found several mutations (single-nucleotide polymorphisms) in the NALP1 gene.The NALP1 gene, which is on chromosome 17 located at 17p13, is on a cascade that regulates inflammation and cell death, including myeloid and lymphoid cells, which are white cells that are part of the immune response. NALP1 is expressed at high levels in T cells and Langerhan cells, white blood cells that are involved in skin autoimmunity. Polymorphisms of CD4 were shown to be associated with the vitiligo and other autoimmune diseases like type I Diabetes Mellitus.^[20]

Among the inflammatory products of NALP1 are caspase 1 and caspase 7, which activate the inflammatory cytokine interleukin-1β. Interleukin-1β is expressed at high levels in patients with vitiligo. There are compounds which inhibit caspase and interleukin-1β, and so might be useful drugs for vitiligo and associated autoimmune diseases. In one of the mutations, the amino acid leucine in the NALP1 protein was replaced by histidine (Leu155->His). The original protein and sequence is highly conserved in evolution, and found in humans, chimpanzee, rhesus monkey, and bush baby, which means that it is an important protein and an alteration is likely to be harmful. Addison's disease (typically an autoimmune destruction of the adrenal glands) may cause vitiligo.^[21][22]

Notable cases[link]

Michael Jackson two years after he was diagnosed with vitiligo universalis, pictured in the early stages of the disease.^[23]

• Michael Jackson was diagnosed with vitiligo in 1986. In a 90-minute interview with Oprah Winfrey in February 1993, Jackson claimed that he didn't bleach his skin, stating for the first time that he had vitiligo. This is further reinforced in the official autopsy report which confirms Jackson's diagnosis with the skin condition.
• Graham Norton, Irish television personality.^[24]
• Lee Thomas, a news anchor and entertainment reporter for WJBK (Fox) Detroit.^[25][26][27]
• Yvette Fielding, British TV presenter, has had vitiligo from age 11; her mother developed it at age 24.^[28][29]
• John Wiley Price, Dallas County Commissioner.^[30]
• Amitabh Bachchan, Bollywood actor.^[31]
• Scott Jorgensen, UFC fighter.^[32]
• Daniel Bryan, professional wrestler, WWE superstar. ^[33]
• Jon Hamm, actor best known for his role in Mad Men.^[34]
• John Henson, one of the hosts of ABC's Wipeout, has vitiligo that has caused a white patch of hair on the right side of his head.^[35]
• Krizz Kaliko, rapper signed with Strange Music. He actually named his debut album Vitiligo (album).

See also[link]

• Albinism, uniform absence of melanin
• Alphos, a non-contagious leprosy formerly referred to as "vitiligo"
• Amelanism, lack of pigmentation
• Chimera (genetics)
• Coloboma
• Erythrism, excessive red pigmentation
• Heterochromia iridum, another condition characterized by pigment variations
• Leucism, reduced pigmentation
• Leukoderma
• List of cutaneous conditions
• Melanism, uniform saturation of melanin
• Nevus depigmentosus
• Piebaldism
• Pityriasis alba
• Quadrichrome vitiligo, characterized by patches of reduced but not absent pigment
• Selective ultraviolet phototherapy
• Uvb_lamps
• Xanthochromism

References[link]

External links[link]

Wikimedia Commons has media related to: Vitiligo

• Vitiligo at the Open Directory Project

Vitiligo Treatment | Uv Therapy

Michael Jackson
Jackson at the White House in 1984
Background information
Birth name	Michael Joseph Jackson[1]
Also known as	King of Pop, MJ
Born	(1958-08-29)August 29, 1958 Gary, Indiana, U.S.
Died	June 25, 2009(2009-06-25) (aged 50) Los Angeles, California, U.S.
Genres	R&B, pop, rock, soul, dance, funk, disco, new jack swing
Occupations	Singer-songwriter, musician, composer, dancer, choreographer, record producer, actor, businessman, philanthropist
Instruments	Vocals
Years active	1964–2009
Labels	Motown, Epic, Legacy, MJJ Productions
Associated acts	The Jackson 5 Michael Jackson's Signature
Website	www.michaeljackson.com

Michael Joseph Jackson^[1] (August 29, 1958 – June 25, 2009) was an American recording artist, entertainer, and businessman. Often referred to as the King of Pop, or by his initials MJ,^[2] Jackson is recognized as the most successful entertainer of all time by Guinness World Records. His contribution to music, dance, and fashion, along with a much-publicized personal life, made him a global figure in popular culture for over four decades. The seventh child of the Jackson family, he debuted on the professional music scene along with his brothers as a member of The Jackson 5 in 1964, and began his solo career in 1971.

In the early 1980s, Jackson became a dominant figure in popular music. The music videos for his songs, including those of "Beat It", "Billie Jean", and "Thriller", were credited with transforming the medium into an art form and a promotional tool, and the popularity of these videos helped to bring the relatively new television channel MTV to fame. Videos such as "Black or White" and "Scream" made him a staple on MTV in the 1990s. Through stage performances and music videos, Jackson popularized a number of complicated dance techniques, such as the robot and the moonwalk, to which he gave the name. His distinctive musical sound and vocal style influenced numerous hip hop, post-disco, contemporary R&B, pop and rock artists.

Jackson's 1982 album Thriller is the best-selling album of all time. His other records, including Off the Wall (1979), Bad (1987), Dangerous (1991), and HIStory (1995), also rank among the world's best-selling. Jackson is one of the few artists to have been inducted into the Rock and Roll Hall of Fame twice. He was also inducted into the Dance Hall of Fame as the first (and currently only) dancer from the world of pop and rock 'n' roll. Some of his other achievements include multiple Guinness World Records; 13 Grammy Awards (as well as the Grammy Legend Award and the Grammy Lifetime Achievement Award); 26 American Music Awards (more than any other artist, including the "Artist of the Century"); 13 number-one singles in the United States in his solo career (more than any other male artist in the Hot 100 era); and the estimated sale of over 750 million records worldwide. Jackson won hundreds of awards, which made him the most-awarded recording artist in the history of popular music.^[3] He was also one of the world's most prominent humanitarians and philanthropists; personally, and through his Heal the World Foundation, he donated more than $300 million in charity, and held the Guinness World Record for having supported the most charities out of any pop star.^[4][5]

Aspects of Jackson's personal life, including his changing appearance, personal relationships, and behavior, generated controversy. In 1993, he was accused of child sexual abuse, but the case was settled out of court and no formal charges were brought. In 2005, he was tried and acquitted of further child sexual abuse allegations and several other charges after the jury found him not guilty on all counts. While preparing for his concert series titled This Is It, Jackson died of acute propofol and benzodiazepine intoxication on June 25, 2009, after suffering from cardiac arrest. The Los Angeles County Coroner ruled his death a homicide, and his personal physician was convicted of involuntary manslaughter. Jackson's death triggered a global outpouring of grief, and as many as one billion people around the world reportedly watched his public memorial service on live television. In March 2010, Sony Music Entertainment signed a $250 million deal with Jackson's estate to retain distribution rights to his recordings until 2017, and to release seven posthumous albums over the decade following his death.^[6]

Life and career[link]

Early life and The Jackson 5 (1958–1975)[link]

Jackson's childhood home in Gary, Indiana, showing floral tributes after his death

Jackson (center) as a member of The Jackson 5 in 1972

Michael Jackson was born on August 29, 1958, the eighth of ten children in an African American working-class family who lived in a small 3-room house in Gary, Indiana,^[7] an industrial city near Chicago. His mother, Katherine Esther Scruse, was a devout Jehovah's Witness, and his father, Joseph Walter "Joe" Jackson, was a steel mill worker who performed with an R&B band called The Falcons. Jackson had three sisters: Rebbie, La Toya, and Janet, and five brothers: Jackie, Tito, Jermaine, Marlon, and Randy.^[8] A sixth brother, Brandon, died shortly after birth.^[9]

Jackson had a troubled relationship with his father, Joe.^[10][11][12] Joseph acknowledged in 2003 that he regularly whipped Jackson as a boy.^[12] Jackson stated that he was physically and emotionally abused during incessant rehearsals, though he also credited his father's strict discipline with playing a large role in his success.^[10] Jackson first spoke openly about his childhood abuse in an interview with Oprah Winfrey, broadcast in February 1993. He admitted that he had often cried from loneliness and he would vomit on the sight of his father. Jackson's father was also said to have verbally abused Jackson, saying that he had a fat nose on numerous occasions.^[13] In fact, Michael Jackson's deep dissatisfaction with his appearance, his nightmares and chronic sleep problems, his tendency to remain hyper-compliant especially with his father, and to remain child-like throughout his adult life are in many ways consistent with the effects of this chronic maltreatment he endured as a young child.^[14]

In an interview with Martin Bashir, later included in the 2003 broadcast of Living with Michael Jackson, Jackson acknowledged that his father hurt him when he was a child, but was nonetheless a "genius", as he admitted his father's strict discipline played a huge role in his success. When Bashir dismissed the positive remark and continued asking about beatings, Jackson put his hand over his face and objected to the questions. He recalled that Joseph sat in a chair with a belt in his hand as he and his siblings rehearsed, and that "if you didn't do it the right way, he would tear you up, really get you".^[15][16]

In 1964, Michael and Marlon joined the Jackson Brothers—a band formed by brothers Jackie, Tito, and Jermaine—as backup musicians playing congas and tambourine. Jackson later began performing backup vocals and dancing. When he was eight, Jackson began sharing the lead vocals with his older brother Jermaine, and the group's name was changed to The Jackson 5.^[8] The band toured the Midwest extensively from 1966 to 1968, frequently performing at a string of black clubs known as the "chitlin' circuit", where they often opened stripteases and other adult acts. In 1966, they won a major local talent show with renditions of Motown hits and James Brown's "I Got You (I Feel Good)", led by Michael.^[17]

The Jackson 5 recorded several songs, including "Big Boy", for the local record label Steeltown in 1967, before signing with Motown Records in 1968.^[8] Rolling Stone magazine later described the young Michael as "a prodigy" with "overwhelming musical gifts," writing that he "quickly emerged as the main draw and lead singer."^[18] The group set a chart record when its first four singles ("I Want You Back", "ABC", "The Love You Save", and "I'll Be There") peaked at number one on the Billboard Hot 100.^[8] Between 1972 and 1975, Michael released four solo studio albums with Motown, among them Got to Be There and Ben, released as part of the Jackson 5 franchise, and producing successful singles such as "Got to Be There", "Ben", and a remake of Bobby Day's "Rockin' Robin".

The Jackson 5 "became a cutting-edge example of black crossover artists... five working-class black boys with afros and bell bottoms, and they really didn't have to trade any of that stuff in order to become mainstream stars."^[19]

The group's sales began declining in 1973, and the band members chafed under Motown's strict refusal to allow them creative control or input. Although they scored several top 40 hits, including the top 5 disco single "Dancing Machine" and the top 20 hit "I Am Love", the Jackson 5 left Motown in 1975.^[20]

[edit] Move to Epic and Off the Wall (1975–81)

In June 1975, the Jackson 5 signed with Epic Records, a subsidiary of CBS Records^[20] and renamed themselves the Jacksons. Younger brother Randy formally joined the band around this time, while Jermaine left to pursue a solo career.^[21] They continued to tour internationally, releasing six more albums between 1976 and 1984, during which Michael was the lead songwriter, writing hits such as "Shake Your Body (Down to the Ground)", "This Place Hotel", and "Can You Feel It".^[17] In 1978, he starred as the scarecrow in the musical, The Wiz, a box-office disaster. It was here that he teamed up with Quincy Jones, who was arranging the film's musical score. Jones agreed to produce Jackson's next solo album, Off the Wall.^[22] In 1979, Jackson broke his nose during a complex dance routine. His subsequent rhinoplasty was not a complete success; he complained of breathing difficulties that would affect his career. He was referred to Dr. Steven Hoefflin, who performed Jackson's second rhinoplasty and subsequent operations.^[23]

Jones and Jackson produced the Off the Wall album together. Songwriters for the album included Jackson, Rod Temperton, Stevie Wonder, and Paul McCartney. Released in 1979, it was the first solo album to generate four U.S. top 10 hits, including the chart-topping singles "Don't Stop 'til You Get Enough" and "Rock with You".^[24][25] It reached number three on the Billboard 200 and eventually sold over 20 million copies worldwide.^[26] In 1980, Jackson won three awards at the American Music Awards for his solo efforts: Favorite Soul/R&B Album, Favorite Soul/R&B Male Artist, and Favorite Soul/R&B Single for "Don't Stop 'Til You Get Enough".^[27][28] That year, he also won Billboard Year-End for Top Black Artist and Top Black Album and a Grammy Award for Best Male R&B Vocal Performance, also for "Don't Stop 'Til You Get Enough".^[24] Jackson again won at the American Music Awards in 1981 for Favorite Soul/R&B Album and Favorite Soul/R&B Male Artist.^[29] Despite its commercial success, Jackson felt Off the Wall should have made a much bigger impact, and was determined to exceed expectations with his next release.^[30] In 1980, he secured the highest royalty rate in the music industry: 37 percent of wholesale album profit.^[31]

[edit] Thriller and Motown 25: Yesterday, Today, Forever (1982–83)

In 1982, Jackson contributed the song "Someone In the Dark" to the storybook for the film E.T. the Extra-Terrestrial; the record won a Grammy for Best Recording for Children in 1984. In the same year he won another seven Grammys and eight American Music Awards (including the Award of Merit, the youngest artist to win it), making him the most awarded in one night for both award shows.^[32][33] These awards were thanks to the Thriller album, released in late 1982, which was 1983's best-selling album worldwide^[34][35] and became the best-selling album of all time in the United States,^[36] as well as the best-selling album of all time worldwide, selling an estimated 110 million copies so far.^[37] The album topped the Billboard 200 chart for 37 weeks and was in the top 10 of the 200 for 80 consecutive weeks. It was the first album to have seven Billboard Hot 100 top 10 singles, including "Billie Jean", "Beat It", and "Wanna Be Startin' Somethin'".^[38] Thriller was certified for 29 million shipments by the RIAA, giving it Double Diamond status in the United States. The album won also another Grammy for Best Engineered Recording – Non Classical in 1984, awarding Bruce Swedien for his work.^[39] Jackson's attorney John Branca noted that Jackson had the highest royalty rate in the music industry at that point: approximately $2 for every album sold. He was also making record-breaking profits from sales of his recordings. The videocassette of the documentary The Making of Michael Jackson's Thriller sold over 350,000 copies in a few months. The era saw the arrival of novelties like dolls modeled after Michael Jackson, which appeared in stores in May 1984 at a price of $12.^[40] Biographer J. Randy Taraborrelli writes that, "Thriller stopped selling like a leisure item—like a magazine, a toy, tickets to a hit movie—and started selling like a household staple."^[41] In 1985, The Making of Michael Jackson's Thriller won a Grammy for Best Music Video, Longform.^[32] In December 2009, the music video for "Thriller" was selected for the National Film Registry by the Library of Congress, "Thriller" is the first music video ever to be inducted.^[42][43][44]

Time described Jackson's influence at that point as "Star of records, radio, rock video. A one-man rescue team for the music business. A songwriter who sets the beat for a decade. A dancer with the fanciest feet on the street. A singer who cuts across all boundaries of taste and style and color too".^[40] The New York Times wrote that, "in the world of pop music, there is Michael Jackson and there is everybody else".^[45]

On March 25th 1983, Michael Jackson reunited with his brothers for a legendary live performance which was taped for a Motown 25: Yesterday, Today, Forever television special. The show aired on May 16, 1983, to an audience of 47 million viewers, and featured the Jacksons and a number of other Motown stars. It is best remembered for Jackson's solo performance of "Billie Jean". Wearing a distinctive black sequin jacket and golf glove decorated with rhinestones, he debuted his signature dance move, the moonwalk, which former Soul Train dancer and Shalamar member Jeffrey Daniel had taught him three years before. The Jacksons' performance drew comparisons to Elvis Presley's and The Beatles' appearances on The Ed Sullivan Show.^[46] Anna Kisselgoff of The New York Times later wrote, "The moonwalk that he made famous is an apt metaphor for his dance style. How does he do it? As a technician, he is a great illusionist, a genuine mime. His ability to keep one leg straight as he glides while the other bends and seems to walk requires perfect timing."^[47]

Pepsi, "We Are the World" and business career (1984–85)[link]

Jackson with a Knott's Berry Farm Snoopy mascot in April 1984

On January 27, 1984, Michael and other members of the Jacksons filmed a Pepsi Cola commercial, overseen by executive Phil Dusenberry,^[48] from ad agency BBDO and Pepsi's Worldwide Creative Director, Alan Pottasch at the Shrine Auditorium in Los Angeles. In front of a full house of fans during a simulated concert, pyrotechnics accidentally set Jackson's hair on fire. He suffered second-degree burns to his scalp. Jackson underwent treatment to hide the scars on his scalp, and he also had his third rhinoplasty shortly thereafter.^[23] Jackson never recovered from this injury. Pepsi settled out of court, and Jackson donated his $1.5 million settlement to the Brotman Medical Center in Culver City, California, which now has a "Michael Jackson Burn Center" in honor of his donation.^[49] Dusenberry later recounted the episode in his memoir, Then We Set His Hair on Fire: Insights and Accidents from a Hall of Fame Career in Advertising.

On May 14, 1984, Jackson was invited to the White House to receive an award from President Ronald Reagan for his support of charities that helped people overcome alcohol and drug abuse.^[50] Jackson won eight awards during the Grammys that year. Unlike later albums, Thriller did not have an official tour to promote it, but the 1984 Victory Tour, headlined by The Jacksons, showcased much of Jackson's new solo material to more than two million Americans. He donated all the funds (around $8 million) raised from the Victory Tour to charity.^[51] He also co-wrote the charity single "We Are the World" in 1985 with Lionel Richie, which was released worldwide to aid the poor in the U.S. and Africa. It became one of the best-selling singles of all time, with nearly 30 million copies sold and millions of dollars donated to famine relief. In 1986, "We Are the World" won four Grammys (one for Jackson for Song of the Year). American Music Award directors removed the charity song from the competition because they felt it would be inappropriate, but recognized it with two special honors (one for the creation of the song and one for the USA for Africa idea). They are the only AMAs that Jackson won as non-solo artist.^{[52][53][54][55]}

Jackson at the White House South Portico with President Ronald Reagan and first lady Nancy Reagan, 1984

In 1984, ATV Music Publishing, which had the copyrights to nearly 4000 songs, including the Northern Songs catalog that contained the majority of the Lennon–McCartney compositions recorded by The Beatles, was put up for sale by Robert Holmes à Court.^[56] Jackson had become interested in owning music catalogs after working with Paul McCartney in the early 1980s: Jackson had learned McCartney made approximately $40 million a year from other people's songs.^[57] In 1981,^[58] McCartney was offered the ATV music catalog for £20 million ($40 million).^[57][59] According to McCartney, he contacted Yoko Ono about making a joint purchase by splitting the cost equally at £10 million each, but Ono thought they could buy it for £5 million each.^[57][59] When they were unable to make the joint purchase, McCartney let the offer fall through, not wanting to be the sole owner of the Beatles' songs.^[58][59]

According to a negotiator for Holmes à Court in the 1984 sale, "We had given Paul McCartney first right of refusal but Paul didn't want it at that time."^[60] Also, an attorney for McCartney assured Jackson's attorney, John Branca, that McCartney was not interested in bidding: McCartney reportedly said "It's too pricey".^[57][58] But there were several other companies and investors bidding. In September 1984, Jackson was first informed about the sale by Branca and sent a bid of $46 million on November 20, 1984.^[56] Jackson's agents thought they had a deal several times, but encountered new bidders or new areas of debate.^[56] In May 1985, Jackson's team walked away from talks after having spent over $1 million on four months of due diligence and on the negotiations.^[56]

In June 1985, Jackson and Branca learned that Charles Koppelman's and Marty Bandier's The Entertainment Co. had made a tentative agreement with Holmes à Court to buy ATV Music for $50 million.^[56] But in early August, Holmes à Court's team contacted Jackson and talks resumed. Jackson raised his bid to $47.5 million and it was accepted because he could close the deal more quickly, having already completed due diligence of ATV Music.^[56] He also agreed to visit Holmes à Court in Australia, where he would appear on the Channel Seven Perth Telethon.^[56][60] Jackson's purchase of ATV Music was finalized August 10, 1985.^[56]

[edit] Appearance, tabloids, Bad, films, autobiography and Neverland (1986–90)

Jackson's skin had been a medium-brown color for the entire duration of his youth, but starting in the mid 1980s, it gradually grew paler. The change gained widespread media coverage, including rumors that he might be bleaching his skin.^[61] According to J. Randy Taraborrelli's biography, in 1986, Jackson was diagnosed with vitiligo and lupus; the vitiligo partially lightened his skin, and the lupus was in remission; both illnesses made him sensitive to sunlight. The treatments he used for his condition further lightened his skin tone, and, with the application of pancake makeup to even out blotches, he could appear very pale.^[62] Jackson was also diagnosed with vitiligo in his autopsy.^[63] By the mid 1990s several surgeons speculated that he had undergone various nasal surgeries, a forehead lift, thinned lips, and cheekbone surgery—although Jackson denied this and insisted that he only had surgery on his nose.^[64] Jackson claimed that he had only two rhinoplasties and no other surgery on his face, although at one point he mentioned having a dimple created in his chin.^[65] Jackson lost weight in the early 1980s because of a change in diet and a desire for "a dancer's body".^[65] Witnesses reported that he was often dizzy and speculated that he was suffering from anorexia nervosa; periods of weight loss would become a recurring problem later in life.^[66]

During the course of his treatment, Jackson made two close friends: his dermatologist, Dr. Arnold Klein, and Klein's nurse Debbie Rowe. Rowe eventually became Jackson's second wife and the mother of his two eldest children. Long before becoming romantically involved with her, Jackson relied heavily on Rowe for emotional support. He also relied heavily on Klein, for medical and business advice.^[67]

Jackson became the subject of increasingly sensational reports. In 1986, the tabloids ran a story claiming that Jackson slept in a hyperbaric oxygen chamber to slow the aging process; he was pictured lying down in a glass box. Although the claim was untrue, according to tabloid reports that are widely cited, Jackson had disseminated the fabricated story himself.^[68][69] When Jackson bought a chimpanzee called Bubbles from a laboratory, he was reported to be increasingly detached from reality.^[70] It was reported that Jackson had offered to buy the bones of Joseph Merrick (the "elephant man") and although untrue, Jackson did not deny the story.^[68][69] Although initially he saw these stories as opportunities for publicity, he stopped leaking untruths to the press as they became more sensational. Consequently the media began making up their own stories.^[69][71][72] These reports became embedded in the public consciousness, inspiring the nickname "Wacko Jacko", which Jackson came to despise.^[73] Responding to the gossip, Jackson remarked to Taraborrelli:

Why not just tell people I'm an alien from Mars? Tell them I eat live chickens and do a voodoo dance at midnight. They'll believe anything you say, because you're a reporter. But if I, Michael Jackson, were to say, "I'm an alien from Mars and I eat live chickens and do a voodoo dance at midnight," people would say, "Oh, man, that Michael Jackson is nuts. He's cracked up. You can't believe a single word that comes out of his mouth."^[74]

Jackson wore a gold-plated military style jacket with belt in the Bad era

Jackson collaborated with George Lucas and Francis Ford Coppola on the 17-minute 3-D film Captain EO, which debuted in September 1986 at both the original Disneyland and at EPCOT in Florida, and in March 1987 at Tokyo Disneyland. The $30 million movie was a popular attraction at all three parks. A Captain EO attraction was later featured at Euro Disneyland after that park opened in 1992. All four parks' Captain EO installations stayed open well into the 1990s: Paris' installation was the last one to close, in 1998.^[75] The attraction would later return to Disneyland in 2010 after Jackson's death.^[76]

In 1987, Jackson disassociated himself from the Jehovah's Witnesses, in response to their disapproval of the Thriller video.^[77] With the industry expecting another major hit, Jackson's first album in five years, Bad (1987), was highly anticipated.^[78] It did not top Thriller as a commercial or artistic triumph, but Bad was still a substantial success in its own right.

The Bad album spawned seven hit singles in the U.S., five of which ("I Just Can't Stop Loving You", "Bad", "The Way You Make Me Feel", "Man in the Mirror" and "Dirty Diana") reached number one on the Billboard Hot 100 charts. This was a record for most number one Hot 100 singles from any one album, including Thriller.^[79] Although the title track's video was arguably derivative of the video for the earlier single "Beat It", the "Bad" video still proved to be one of Jackson's iconic moments. It was a gritty but colorful epic set against the backdrop of the New York City Subway system, with costuming and choreography inspired by West Side Story. As of 2012, the album sold between 30 and 45 million copies worldwide.^{[80][81][82][83][84][85][86]} Thanks to the Bad album, Bruce Swedien and Humberto Gatica won one Grammy in 1988 for Best Engineered Recording – Non Classical and Michael Jackson won one Grammy for Best Music Video, Short Form for "Leave Me Alone" in 1989.^[32][39] In the same year, Jackson won an Award of Achievement at the American Music Awards because Bad is the first album ever to generate five number one singles in the US, the first album to top in 25 countries and the best-selling album worldwide in 1987 and in 1988.^{[87][88][89][90]} In 1988, "Bad" won an American Music Award for Favorite Soul/R&B Single.^[91]

Front view: Jackson wearing the costume on a June 2, 1988 performance in Vienna, Austria

The Bad World Tour began on September 12 that year, finishing on January 14, 1989.^[92] In Japan alone, the tour had 14 sellouts and drew 570,000 people, nearly tripling the previous record of 200,000 in a single tour.^[93] Jackson broke a Guinness World Record   when 504,000 people attended seven sold-out shows at Wembley Stadium. He performed a total of 123 concerts to an audience of 4.4 million people. The Bad Tour turned out to be the last of Jackson's concert tours to include shows in the continental United States, although later tours did make it to Hawaii.

In 1988, Jackson released his first and only autobiography, Moonwalk, which took four years to complete and sold 200,000 copies.^[94] Jackson wrote about his childhood, The Jackson 5, and the abuse he had suffered.^[95] He also wrote about his facial appearance, saying he had had two rhinoplastic surgeries and a dimple created in his chin.^[65] He attributed much of the change in the structure of his face to puberty, weight loss, a strict vegetarian diet, a change in hair style, and stage lighting.^[65] Moonwalk reached the top position on The New York Times best sellers' list.^[96] The musician then released a film called Moonwalker, which featured live footage and short films that starred Jackson and Joe Pesci. The film was originally intended to be released to theaters but due to financial issues, the film was released direct-to-video. It saw a theatrical release in Germany, though. It debuted atop the Billboard Top Music Video Cassette chart, staying there for 22 weeks. It was eventually knocked off the top spot by Michael Jackson: The Legend Continues.^[97]

In March 1988, Jackson purchased land near Santa Ynez, California, to build Neverland Ranch at a cost of $17 million. He installed Ferris wheels, a menagerie, and a movie theater on the 2,700-acre (11 km²) property. A security staff of 40 patrolled the grounds. In 2003, it was valued at approximately $100 million.^[18][98] In 1989, his annual earnings from album sales, endorsements, and concerts was estimated at $125 million for that year alone.^[99] Shortly afterwards, he became the first Westerner to appear in a television ad in the Soviet Union.^[97]

His success resulted in his being dubbed the "King of Pop".^{[100][101][102][103]} The nickname was popularized by Elizabeth Taylor when she presented him with the Soul Train Heritage Award in 1989, proclaiming him "the true king of pop, rock and soul."^[104] President George H. W. Bush designated him the White House's "Artist of the Decade".^[105] From 1985 to 1990, he donated $500,000 to the United Negro College Fund, and all of the profits from his single "Man in the Mirror" went to charity.^[106][107] Jackson's live rendition of "You Were There" at Sammy Davis Jr.'s 60th birthday celebration received an Emmy nomination.^[97]

[edit] Dangerous, Heal the World Foundation and Super Bowl XXVII (1991–93)

In March 1991, Jackson renewed his contract with Sony for $65 million, a record-breaking deal at the time,^[108] displacing Neil Diamond's renewal contract with Columbia Records.^[109] He released his eighth album Dangerous in 1991. As of 2008, Dangerous had shipped seven million copies in the U.S. and had sold 32 million copies worldwide. The Dangerous album was co-produced by Teddy Riley, one of the pioneers of "new jack swing" which convinced Michael to feature a rapper on his album for the first time, the act worked and it turned out to be the best-selling album associated with that movement.^{[110][111][112]} In the United States, the album's first single "Black or White" was its biggest hit, reaching number one on the Billboard Hot 100 and remaining there for seven weeks, with similar chart performances worldwide.^[113] The album's second single "Remember the Time" spent eight weeks in the top five in the United States, peaking at number three on the Billboard Hot 100 singles chart.^[114] At the end of 1992, Dangerous was awarded 1992's best-selling album worldwide and "Black or White" was awarded 1992's best-selling single worldwide at the Billboard Music Awards. Additionally, he won an award as best-selling artist of the '80s.^[115] In 1993, Jackson performed the song at the Soul Train Music Awards in a chair, saying he had suffered an injury in rehearsals.^[116] In the UK and other parts of Europe, "Heal the World" was the biggest hit from the album; it sold 450,000 copies in the UK and spent five weeks at number two in 1992.^[114]

Jackson founded the Heal the World Foundation in 1992. The charity organization brought underprivileged children to Jackson's ranch to enjoy theme park rides that Jackson had built on the property. The foundation also sent millions of dollars around the globe to help children threatened by war, poverty, and disease. In the same year Jackson published his second book, the bestselling collection of poetry, Dancing the Dream. While it was a commercial success and revealed a more intimate side to Jackson's nature, the collection was mostly critically unacclaimed at the time of release. In 2009, the book was republished by Doubleday and was more positively received by some critics in the wake of Jackson's untimely death. The Dangerous World Tour grossed $100 million. The tour began on June 27, 1992, and finished on November 11, 1993. Jackson performed to 3.5 million people in 67 concerts.^[114][117] He sold the broadcast rights to his Dangerous world tour to HBO for $20 million, a record-breaking deal that still stands.^[118]

Following the illness and death of Ryan White, Jackson helped draw public attention to HIV/AIDS, something that was still controversial at the time. He publicly pleaded with the Clinton Administration at Bill Clinton's Inaugural Gala to give more money to HIV/AIDS charities and research.^[119][120] In a high-profile visit to Africa, Jackson visited several countries, among them Gabon and Egypt.^[121] His first stop to Gabon was greeted with a sizable and enthusiastic reception of more than 100,000 people, some of them carrying signs that read, "Welcome Home Michael."^[121] In his trip to Côte d'Ivoire, Jackson was crowned "King Sani" by a tribal chief.^[121] He then thanked the dignitaries in French and English, signed official documents formalizing his kingship and sat on a golden throne while presiding over ceremonial dances.^[121]

In January 1993, Jackson made a memorable appearance at the halftime show at Super Bowl XXVII. The performance began with Jackson catapulting onto the stage as fireworks went off behind him. As he landed on the canvas, he maintained a motionless "clenched fist, standing statue stance", dressed in a gold and black military outfit and sunglasses; he remained completely motionless for a minute and a half while the crowd cheered. He then slowly removed his sunglasses, threw them away and sang four songs: "Jam", "Billie Jean", "Black or White" and "Heal the World". It was the first Super Bowl where the audience figures increased during the half-time show, and was viewed by 135 million Americans alone; Jackson's Dangerous album rose 90 places up the album chart.^[61] Jackson was given the "Living Legend Award" at the 35th Grammy Awards in Los Angeles. "Black or White" was Grammy-nominated for best vocal performance. "Jam" gained two nominations: Best R&B Vocal Performance and Best R&B Song.^[114] The Dangerous album won a Grammy for Best Engineered – Non Classical, awarding the work of Bruce Swedien and Teddy Riley. In the same year, Michael Jackson won three American Music Awards for Favorite Pop/Rock Album (Dangerous), Favorite Soul/R&B Single ("Remember the Time") and was the first to win the International Artist Award, for his global performances and humanitarian concerns. This award will bear his name in the future.^{[32][39][122]}

First child sexual abuse allegations and first marriage (1993–94)[link]

Jackson gave a 90-minute interview to Oprah Winfrey on February 10, 1993, his second television interview since 1979. He grimaced when speaking of his childhood abuse at the hands of his father; he believed he had missed out on much of his childhood years, admitting that he often cried from loneliness. He denied tabloid rumors that he had bought the bones of the Elephant Man, slept in a hyperbaric oxygen chamber, or bleached his skin, stating for the first time that he had vitiligo. The interview was watched by an American audience of 90 million. Dangerous re-entered the album chart in the top 10, more than a year after its original release.^{[16][61][114]}

In the summer of 1993, Jackson was accused of child sexual abuse by a 13-year-old boy named Jordan Chandler and his father, Dr. Evan Chandler, a dentist.^{[123][124][125]} The Chandler family demanded payment from Jackson, and the singer initially refused. Jordan Chandler eventually told the police that Jackson had sexually abused him.^[126] Dr. Chandler was tape-recorded discussing his intention to pursue charges, saying, "If I go through with this, I win big-time. There's no way I lose. I will get everything I want and they will be destroyed forever ... Michael's career will be over". Jordan's mother was, however, adamant that there had been no wrongdoing on Jackson's part.^[125] Jackson later used the recording to argue that he was the victim of a jealous father whose only goal was to extort money from the singer.^[125]

Later that year, on December 20, Jackson's home was raided by the police, and Jackson submitted to a 25-minute strip search.^[127] Jordan Chandler had reportedly given police a description of Jackson's intimate parts, notably claiming that his bleach-damaged penis was circumcised; the strip search revealed, to the contrary, that Jackson was actually uncircumcised,^[128] a fact confirmed in his autopsy.^[129] His friends said he never recovered from the humiliation of the strip search. The investigation was inconclusive and no charges were ever filed.^[130][131] Jackson described the search in an emotional public statement, and proclaimed his innocence.^{[123][127][132]} On January 1, 1994, Jackson's insurance carrier settled with the Chandlers out of court for $22 million. A Santa Barbara County grand jury and a Los Angeles County grand jury disbanded on May 2, 1994 without indicting Jackson.^[133] After which time the Chandlers stopped co-operating with the criminal investigation around July 6, 1994.^{[134][135][136]} The out-of-court settlement's documentation specifically stated Jackson admitted no wrongdoing and no liability; the Chandlers and their family lawyer Larry Feldman signed it without contest.^[137] The Chandlers' lawyer Mr. Feldman also explicitly stated "nobody bought anybody's silence".^[138] A decade after the fact, during the second round of child abuse allegations, Jackson's lawyers would file a memo stating that the 1994 settlement was done without his consent.^[135]