REPORT OF A CASE
A 4-month-old white girl was referred for evaluation of dermatitis present since birth. The patient's mother described the dermatitis as initially being "bluish," which later developed into "reddish indented areas."The physical examination revealed erythematous, scaling, annular plaques involving the face periorbitally in a masklike distribution (Fig 1). Similar plaques, exhibiting central atrophy, were noted on the scalp, the upper aspect of the back, the arms, the buttocks, and the dorsa of the feet. Otherwise, the physical examination was normal.The electrocardiogram was normal. Laboratory data were negative or normal for complete blood cell count and automated blood chemistry evaluations.Representative sections of the biopsy specimen are shown in Figs 2 and 3.What is your diagnosis?
Neonatal lupus erythematosus (NLE).
At the age of 4 months, the child was noted to have a positive antinuclear antibody (ANA) with a titer of 1:320 (speckled pattern), a positive anti-nDNA antibody with a titer of 1:10, and a positive anti-Ro/SSA antibody