2.1 | Case 1
A
15-day-old girl
(patient
1) presented to the dermatology clinic with erythema on her body in
October 2015. The patient 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), her trunk, and her arms and legs,
involving her palms and
the soles of her feet (Fig. 1b).
Laboratory studies showed the liver
and kidney functions, blood routine tests were normal.
Serologic autoantibody test
found
both the SSA (Ro) and SSB (La) were strongly positive,
ANA
was
reactive 1:1000 with multiple
nuclear dots. Syphilis serological
test was negative. The newborn’s
echocardiogram and electrocardiogram
(ECG) were normal. Cutaneous manifestations of the
neonatal
lupus erythematosus (NLE) were
confirmed by clinical features and serology tests. Further questioning,
the mother described having dry mouth
for more than 2 years, and she was referred to a rheumatologist and
received a diagnosis of
Sjögren’s syndrome, treated it with
prednisone
20mg/d, reduced to 10mg/d after 3 years, and hydroxychloroquine 400mg/d.
The patient was protected from the
sun, and the rash resolved after 6 months without specific therapy
because there were no symptoms.