White patches of skin under Prince Michael's arm were noticeably visible when he wore swim trunks on a recent Hawaiian vacation, prompting speculation that the skin-bleaching disorder vitiligo could be the cause.
Michael Jackson said the condition was to blame for the gradual but steady lightening of his own skin and with his 13-year-old son displaying similar symptoms, skeptics who question the paternity of Jackson’s children may finally be convinced that the singer really was the teen's biological father.
But vitiligo, an autoimmune disease, is not always an inherited disorder, Dr. Doris Day, an attending dermatologist at Lenox Hill Hospital, told the Daily News.
"Getting vitiligo because a parent has it could happen," she said. "But it's not necessarily a direct correlation."
Parents can pass down the propensity for an autoimmune condition, but the child of a parent with one autoimmune condition could just as easily have another autoimmune disease or none at all.
In an autoimmune disorder, the body attacks itself. In vitiligo, the person’s own immune system attacks the melanin in the skin, which is what determines skin color, explained Dr. Kent Holtorf.
"Vitiligo often starts in adolescence or early adulthood," he said. "Sometimes just a little virus can set it off."
The disorder typically begins in areas around the eyes or the mouth, or the backs of hands, according to Day, who says it would be unusual for it to start under the arms.
"You don’t typically see it starting in that spot," she said.
While not contagious, it can be difficult to treat. And though it’s not known just what sets off vitiligo, stress may play a part.
"Stress seems to make it worse," Day said. "If a skin condition like vitiligo is what you are prone to, then that is what will come out when you’re stressed."
The white patches of skin under Prince Michael's arm could also have been caused by a bad bug bite or even a severe cut that left the skin discolored, Day said. If this were the case, the lack of pigment, or post-inflammatory hypopigmentation, could be severe enough that it wouldn't fade over time.
Some birth marks also can be white, Day said, although this is not common. Eczema could be another cause of the white patches.
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