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Seeing double: annular diaper rash in twins
Lacy L Sommer1, Steven M Manders1
1Cooper Medical School of Rowan University, Camden, New Jersey.
Pediatric Dermatology
|February 3, 2015
Summary
Neonatal lupus erythematosus can present as unusual skin rashes in infants. This case highlights the importance of considering this condition in newborns with persistent, atypical skin findings.
Area of Science:
- Dermatology
- Neonatology
- Immunology
Background:
- Neonatal lupus erythematosus (NLE) is a rare condition caused by transplacental passage of maternal autoantibodies.
- It can manifest with various cutaneous and systemic features, often affecting sun-exposed areas.
Observation:
- This report details a case of dichorionic, diamniotic twins presenting with similar erythematous, annular, erosive plaques in the inguinal folds.
- The lesions were resistant to standard treatments like topical antifungals and oral antibiotics.
Findings:
- The twins exhibited elevated transaminase levels and tested positive for antinuclear antibodies (ANA), including anti-SSA/Ro and anti-SSB/La autoantibodies.
- The characteristic rash resolved completely without scarring by seven months of age with the application of low-potency topical corticosteroids.
Implications:
- Physicians should consider NLE in neonates presenting with atypical skin eruptions, even in sun-protected areas.
- Early recognition and appropriate management, such as with topical corticosteroids, can lead to favorable outcomes without scarring.
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