[Neonatal cutaneous lupus. Necessary interdisciplinary collaboration]

Area of Science:

• Neonatal immunology
• Autoimmune disorders in pregnancy
• Pediatric dermatology

Background:

• Neonatal lupus erythematosus (NLE) is a rare condition affecting infants born to mothers with autoimmune diseases like lupus.
• It is caused by the transplacental transfer of maternal autoantibodies, primarily anti-SSA/Ro and anti-SSB/La.
• NLE classically presents with skin lesions and/or congenital heart block.

Observation:

• A case of NLE is presented in an infant whose mother has systemic lupus erythematosus and Gougerot-Sjögren's syndrome.
• The mother had a history of positive antinuclear, anti-DNA, anti-SSA, anti-SSB, and anticardiolipin antibodies.
• The infant developed erythematous cutaneous lesions with atrophic centers four weeks after birth, despite prenatal monitoring and treatment.

Findings:

• Cutaneous lesions in neonatal lupus erythematosus can emerge as late as four weeks after birth.
• The infant's lesions showed partial regression without systemic treatment.
• Congenital heart block was not observed in this case, but skin manifestations were present.

Implications:

• Pediatricians must maintain clinical vigilance for NLE symptoms in infants born to mothers with anti-SSA or anti-SSB antibodies.
• Extended monitoring, at least through the first seven months of life, is crucial for early detection and management.
• This case highlights the variable timing of NLE symptom onset and the importance of continued observation.