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.