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Neonatal lupus presenting as a non-specific rash in primary care
  1. Heather Bernard1,2 and
  2. Corinna Rea1,2
  1. 1Harvard Medical School, Boston, Massachusetts, USA
  2. 2Boston Children's Hospital Division of General Pediatrics, Boston, Massachusetts, USA
  1. Correspondence to Dr Heather Bernard; heather.bernard{at}childrens.harvard.edu

Abstract

Neonatal lupus erythematosus is a rare autoimmune disease caused by passive transplacental acquisition of maternal autoantibodies manifesting in cutaneous, cardiac, haematological and hepatobiliary abnormalities. The hallmark dermatological finding is erythematous annular lesions with a predilection for photo-exposed areas of the skin. We present a case of a female infant born to a mother with Sjogren’s syndrome, who initially presented to an ambulatory care setting with non-specific erythematous papules involving the face and scalp. Within 6 days the rash changed in appearance, consisting of widespread erythematous annular and polycyclic lesions with central violaceous clearing and atrophy. Serological tests revealed asymptomatic anemia and leukopenia, elevated liver enzymes, and positive antinuclear antibodies (ANA) and anti-SSb/La antibodies. Further cardiac evaluation was normal. She was managed conservatively in the outpatient setting with topical steroids, avoidance of sunlight and fluorescent light exposure, and primary care, rheumatological and dermatological follow-up.

  • neonatal health
  • dermatology

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Footnotes

  • Contributors HB developed the conception and design of the case report, gathered the appropriate data and information for the case report, and wrote the initial draft. Critical appraisal and article revision was performed by CR. Together, both coedited the final version submitted for publication. Both HB and CR agree to be accountable for ensuring accuracy and integrity of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.