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Neonatal lupus erythematosus occurring in identical twins
M Shimosegawa1, T Akasaka, M Matsuta
1Department of Dermatology, Iwate Medical University, Morioka, Japan.
The Journal of Dermatology
|November 14, 1997
Summary
Neonatal lupus erythematosus (NLE) presented as scaly erythema in identical twins, resolving spontaneously. Both infants and their mother showed positive autoantibodies, suggesting a genetic predisposition.
Area of Science:
- Dermatology
- Immunology
- Genetics
Background:
- Neonatal lupus erythematosus (NLE) is an autoimmune condition affecting infants, often associated with maternal autoantibodies.
- Infants of mothers with anti-SS-A/Ro and anti-SS-B/La antibodies are at risk for NLE.
- Cutaneous manifestations are common, but cardiac involvement can also occur.
Observation:
- Identical twins presented with scaly erythema on the trunk, face, and scalp around 2-3 weeks after birth.
- The skin eruptions resolved spontaneously by two months of age without any treatment.
- The mother reported a history of transient facial erythema.
Findings:
- Both twins and their mother tested positive for antinuclear antibody (ANA), anti-SS-A, and anti-SS-B antibodies.
- Histopathological examination of skin lesions was consistent with discoid lupus erythematosus (DLE).
- HLA typing revealed Cw3 in both twins and A24 in the mother, both associated with NLE.
Implications:
- This case highlights the potential for NLE to affect identical twins.
- The presence of specific autoantibodies and HLA types in both twins and the mother suggests a strong genetic and immunological link.
- Understanding these associations aids in diagnosing and managing NLE and its potential recurrence.