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.