It seems real, I guess that what we can see on his face is the beginning of his vitiligo, might be acne treatment cream too, as it looks "liquid", i don't know how to say that. However, that blue/purple arm is odd, maybe a bruise or something, but it seems serious as it's all over his arm.
Did some reverse image search, the photo is real but the original seems to be black and white and people have colourised it. You can tell by looking at the phone.
Here's the black and white one:
<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Your camera roll if Michael Jackson was your boyfriend; a thread <a href="https://t.co/2MXPjYrYyl">pic.twitter.com/2MXPjYrYyl</a></p>— ♕ (@smilexmj) <a href="https://twitter.com/smilexmj/status/1257707231103066114?ref_src=twsrc%5Etfw">May 5, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>