Neonatal Lupus Erythematosus

Neonatal lupus erythematosus is a rare condition, although it is likely to be underdiagnosed because of the transient nature of the cutaneous signs. Recognition and timely diagnosis are of prognostic importance for both baby and mother. Neonatal lupus is characterized by annular and/or diffuse erythematous lesions seen most commonly on the face and scalp, which may occur in association with systemic disease, notably heart block (usually complete heart block) and/or liver dysfunction and/or thrombocytopaenia. Whilst skin lesions are transient, congenital heart block, when complete, is permanent despite interventions to date. The neonatal lupus syndrome is a passively acquired autoimmune disorder, resulting from the transplacental passage of maternal anti-Ro/SSA antibodies with or without anti-La/SSB or rarely anti-RNP antibodies. Treatment is generally supportive, with monitoring and management of systemic complications, avoidance of sun exposure and investigation of the mother for connective tissue disease.