3.1 | Case 1
In
October 2015, a 15-day-old girl (patient 1) was presented at the
dermatology clinic with erythema on her body. She was born full term to
a 29-year-old Chinese woman via normal spontaneous vaginal delivery.
Physical examination revealed that
targetoid
erythematous plaques with central atrophy and raised margins were
present on her face
(Fig.
1a), trunk, arms, legs, palms, and soles of her feet (Fig. 1b).
Laboratory studies showed the liver
and kidney functions, blood routine tests were normal.
Serologic autoantibody tests
revealed strongly positive SSA (Ro) and SSB (La) antibodies, and a
reactive ANA of 1:1000 with multiple nuclear dots. Syphilis serological
test was negative. Normal results were obtained from the newborn’s
echocardiogram and electrocardiogram (ECG). Finally,
cutaneous manifestations of the
neonatal
lupus erythematosus (NLE) were
confirmed by clinical features and serology tests.
Further questioning, the infant’s mother described having dry mouth for
more than 2 years, and was subsequently diagnosed with Sjögren’s
syndrome. She was treated with prednisone 20mg/d, reduced to 10mg/d
after 3 years, and hydroxychloroquine 400mg/d. The patient 1 was
protected from the sun, and the rash
resolved after 6 months without specific therapy due to the absence of
symptoms.