A clinical image of cutaneous neonatal lupus erythematosus

A 1-month-old female child presented with erythematous lesions over the chest and abdomen for 1 week of life. The lesions had a well-defined border and lighter-coloured centre on the chest and abdomen (Fig. 1). As per the mother, the baby was otherwise well and gaining weight. General and systemic examinations were within normal limits. The patient was previously treated for tinea corporis but showed no improvement on topical anti-fungals. The mother was a known case of systemic lupus erythematosus. Laboratory findings showed normal haemogram, liver function tests and strongly positive anti-nuclear antibodies (ANA) 1:640, but negative anti-Ro and anti-La antibodies. The electrocardiogram as well as two-dimensional echocardiogram were normal, while the skin biopsy exhibited lymphocytic infiltration in histology. Direct immunofluorescence revealed the presence of immunoglobulins and complement at the dermal–epidermal junction. Mother was also positive for ANA (1:640) and anti-Ro but there were no detectable anti-La or Smith antibodies. What is the diagnosis? (Answer on page ••) Cutaneous neonatal lupus erythematosus.