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Published on: September 20, 2018
Periorbital cutaneous neonatal lupus.
Rani M Cooper1, David F Butler, Fred Ghali
1Department of Medicine, Division of Dermatology, Scott and White Memorial Hospital and Clinic, 409 Adams Street, Temple, TX 76508, USA.
Skinmed
|May 8, 2007
Summary
This study highlights a rare facial rash in infants, often linked to maternal autoimmune conditions like Sjögren syndrome. Early diagnosis and treatment, including sun protection, can effectively manage this photosensitive eruption.
Area of Science:
- Pediatric Dermatology
- Neonatal Immunology
- Maternal-Fetal Medicine
Background:
- Infantile periorbital eruptions can present as photosensitive facial dermatitis.
- These rashes may be associated with maternal autoimmune diseases, particularly Sjögren syndrome.
- Anti-SSA antibodies are frequently detected in affected infants and their mothers.
Observation:
- Three infant girls presented with similar annular, polycyclic, erythematous, scaly plaques on the face, predominantly periorbital.
- All infants had positive anti-SSA antibodies, with one also testing positive for anti-SSB antibodies.
- Maternal evaluations revealed positive anti-SSA antibodies in two mothers, with one having a history of Sjögren syndrome.
Findings:
- Infant facial eruptions showed a strong association with maternal anti-SSA antibody positivity.
- Skin lesions responded to topical treatments such as desonide cream or tacrolimus ointment, combined with sun protection.
- Cardiac evaluations and electrocardiograms in the infants were normal, ruling out significant congenital heart block.
Implications:
- Maternal anti-SSA antibody screening should be considered in infants with persistent photosensitive facial rashes.
- Prompt diagnosis and management, including photoprotection, can lead to favorable dermatological outcomes.
- This finding underscores the importance of understanding transplacental antibody transfer in neonatal skin conditions.