Skin-Limited Neonatal Lupus in an Infant Conceived by In Vitro Fertilization and Surrogate Gestation

Neonatal lupus erythematosus (NLE) is a rare autoimmune condition caused by the transplacental passage of maternal anti-Ro/SSA and anti-La/SSB antibodies, typically presenting with annular erythema or congenital heart block. We report a 3-month-old infant conceived by in vitro fertilization and carried by a surrogate mother who developed annular erythematous plaques in typical and atypical locations at 1 month of age. Skin biopsy and serologic testing confirmed NLE despite the absence of a known maternal autoimmune history; maternal anti-Ro/SSA and anti-La/SSB positivity was identified retrospectively through the surrogate's obstetrician. The cutaneous findings improved significantly with photoprotection and resolved without systemic involvement.